Pediatric surgery international · 2019
Management of Hirschsprung disease in Australia and New Zealand: a survey of the Australian and New Zealand Association of Paediatric Surgeons (ANZAPS).
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nataraja Ramesh Mark, Ferguson Peter, King Sebastian, Lynch Amiria, Pacilli Maurizio
Аннотация
PURPOSE: To define the practice of management for Hirschsprung disease (HD) in Australia and New Zealand.
METHODS: Online survey of Australian and New Zealand Association of Paediatric Surgeons (ANZAPS) members.
RESULTS: 56/80 (70%) members from 17 centres responded.
DIAGNOSIS: 100% perform suction rectal biopsies; 40% perform a contrast enema.
HISTOPATHOLOGICAL STAINING: H&E (94%), ACHE (70%) and calretinin (75%).
SURGERY: Primary pull-through (PT) is performed by 88% (100% by < 6/12 months). The Soave-Boley PT is the preferred approach (85%), with laparoscopic assistance (77%) and muscle cuff division (93%). Routine post-operative dilatations are performed by 63% of respondents. If symptoms persist following PT, majority adopt a conservative approach (enemas/laxatives 90%; Botox 74%). If a long-segment is identified at PT, 60% fashion a stoma and delay definitive surgery. If total colonic aganglionosis is identified at PT, 76% fashion a stoma and delay definitive surgery. A dedicated bowel management program is available in 45% of centres with transition to adult services in 29%.
CONCLUSIONS: A laparoscopic-assisted Soave-Boley PT is the most common technique for recto-sigmoid HD. Differences are noted in both the management of long-segment/total aganglionosis HD and post-operative management/follow-up.
METHODS: Online survey of Australian and New Zealand Association of Paediatric Surgeons (ANZAPS) members.
RESULTS: 56/80 (70%) members from 17 centres responded.
DIAGNOSIS: 100% perform suction rectal biopsies; 40% perform a contrast enema.
HISTOPATHOLOGICAL STAINING: H&E (94%), ACHE (70%) and calretinin (75%).
SURGERY: Primary pull-through (PT) is performed by 88% (100% by < 6/12 months). The Soave-Boley PT is the preferred approach (85%), with laparoscopic assistance (77%) and muscle cuff division (93%). Routine post-operative dilatations are performed by 63% of respondents. If symptoms persist following PT, majority adopt a conservative approach (enemas/laxatives 90%; Botox 74%). If a long-segment is identified at PT, 60% fashion a stoma and delay definitive surgery. If total colonic aganglionosis is identified at PT, 76% fashion a stoma and delay definitive surgery. A dedicated bowel management program is available in 45% of centres with transition to adult services in 29%.
CONCLUSIONS: A laparoscopic-assisted Soave-Boley PT is the most common technique for recto-sigmoid HD. Differences are noted in both the management of long-segment/total aganglionosis HD and post-operative management/follow-up.