BMC pediatrics · 2025
Analysis of the causes of redo pull-through for recurrent constipation and the risk factors affecting the prognosis of the Hirschsprung's disease: a single-center retrospective study and systematic review.
Сравнительное исследованиеСтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Xiao Jun, Yang Shimin, Xiang Lei, Qin Bo, You Jingyi, Dong Mei, Xie Youshan, Zhang Xuan, Chen Xuyong, Li Zejian, Li Honglin, Feng Jiexiong
Аннотация
BACKGROUND: Hirschsprung's disease (HSCR) is a congenital gastrointestinal disorder. Pull-through (PT) surgery, the primary treatment, often leads to recurrent constipation. The causes of redo pull-through (redo-PT) for recurrent constipation remain unclear, with limited research on follow-up outcomes and prognostic factors.
METHODS: We searched "PubMed" and "Web of Science" for references using the title/abstract terms "Hirschsprung" and "Redo pull-through". We enrolled patients from the literature review group and our retrospective group who underwent redo-PT for recurrent constipation. A comparative analysis was conducted between two groups based on the clinical information for redo-PT.
RESULTS: A total of 360 cases were collected from the references (327 patients) and our center (33 patients). Recurrent aganglionosis (RA) and Mechanical Obstruction (MO) were the primary reasons for redo-PT, accounting for 52.50% and 36.67%, respectively. When comparing the causes of redo-PT between the literature group and our center group, RA accounted for 49.85% and 75.76%, while MO accounted for 49.85% and 21.21%, respectively. Prognostic outcomes of 31 patients from our center were analyzed, revealing no significant associations between postoperative complications and gender, age, causes of redo pull-through, or surgical approach (P > 0.05).
CONCLUSIONS: Recurrent constipation requiring redo-PT are predominantly caused by RA and MO. Gender, age, causes of redo pull-through, or surgical approach do not affect the prognosis of redo-PT. The laparoscopic approach demonstrated superior cosmetic outcomes compared to the laparotomy approach.
METHODS: We searched "PubMed" and "Web of Science" for references using the title/abstract terms "Hirschsprung" and "Redo pull-through". We enrolled patients from the literature review group and our retrospective group who underwent redo-PT for recurrent constipation. A comparative analysis was conducted between two groups based on the clinical information for redo-PT.
RESULTS: A total of 360 cases were collected from the references (327 patients) and our center (33 patients). Recurrent aganglionosis (RA) and Mechanical Obstruction (MO) were the primary reasons for redo-PT, accounting for 52.50% and 36.67%, respectively. When comparing the causes of redo-PT between the literature group and our center group, RA accounted for 49.85% and 75.76%, while MO accounted for 49.85% and 21.21%, respectively. Prognostic outcomes of 31 patients from our center were analyzed, revealing no significant associations between postoperative complications and gender, age, causes of redo pull-through, or surgical approach (P > 0.05).
CONCLUSIONS: Recurrent constipation requiring redo-PT are predominantly caused by RA and MO. Gender, age, causes of redo pull-through, or surgical approach do not affect the prognosis of redo-PT. The laparoscopic approach demonstrated superior cosmetic outcomes compared to the laparotomy approach.