Patterns of postoperative enterocolitis in children with Hirschsprung's disease combined with hypoganglionosis.
OBJECTIVE
The relationship between postoperative enterocolitis (EC) and Hirschsprung's disease (HD) combined with hypoganglionosis (HYP) has not been thoroughly reported elsewhere. The aim of this study was to investigate the incidence of EC after operation in children with HD combined with HYP and to identify new strategies to prevent postoperative EC.


METHODS
From 1998 to 2005, 97 children with HD underwent the modified Swenson's procedure in this institute. They were classified into 2 groups based on pathologic investigation as follows: group A contained 70 patients with HD and group B contained 27 patients with HD complicated with HYP. The mean follow-up time from the time of the operation was 3.4 years (range, 1.5-8 years). The incidence of postoperative EC and anorectal functions were evaluated and compared between these 2 groups.


RESULTS
Eight cases (11.4%) in group A developed postoperative EC, whereas 11 (40.7%) in group B did so. The incidence of postoperative EC in group A was significantly lower than that in group B (P < .005). According to the Rintala scoring system, the percentage of patients with an excellent score in group A (85.7%) was significantly higher than that in group B (P < .05). The recurrence rate of constipation in group B was 14.8% (4/27), whereas it was 2.8% (2/70) in group A.


CONCLUSIONS
Postoperative EC is associated with retained proximal HYP, which suggests that HYP could be, at minimum, a predictive marker for this complication. Complete resection of HYP segment could potentially minimize the incidence of postoperative EC and alleviate the severity of EC.
Wu
Xiaojuan
X
Department of Pediatric Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Feng
Jiexiong
J
Wei
Mingfa
M
Guo
Xiane
X
Li
Runguang
R
Xuan
Xiaoqi
X
Yang
Jixin
J
D000714:Anastomosis, Surgical / Q000009:adverse effects; D001706:Biopsy; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003082:Colectomy / Q000009:adverse effects*; D003106:Colon / Q000473:pathology / Q000601:surgery*; D004760:Enterocolitis / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005500:Follow-Up Studies; D006627:Hirschsprung Disease / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007413:Intestinal Mucosa / Q000473:pathology; D011183:Postoperative Complications; D011379:Prognosis; D013997:Time Factors