Faculty Collaboration Database

Comparison of Hirschsprung Disease Characteristics between Those with a History of Postoperative Enterocolitis and Those without: Results from the Pediatric Colorectal and Pelvic Learning Consortium. Eur J Pediatr Surg 2021 Jun;31(3):207-213

Date

09/19/2020

Pubmed ID

32947626

DOI

10.1055/s-0040-1716876

Scopus ID

2-s2.0-85091749516 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

INTRODUCTION:  The current understanding of Hirschsprung-associated enterocolitis (HAEC) is based mainly on single-center, retrospective studies. The aims of this study are to determine risk factors for postoperative HAEC using the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) database.

MATERIALS AND METHODS:  We performed a multicenter, retrospective, case-control study of children with Hirschsprung disease (HD) who had undergone a pull-through procedure and were evaluated at a PCPLC member site between February 2017 and March 2020. The cohort with a history of postoperative HAEC was compared with that without postoperative episodes of HAEC to determine relevant associations with postoperative HAEC.

RESULTS:  One-hundred forty of 299 (46.8%) patients enrolled had a history of postoperative HAEC. Patients with a rectosigmoid transition zone had a lower association with postoperative HAEC as compared with those with a more proximal transition zone (odds ratio [OR]: 0.46, 95% confidence interval [CI]: 0.26, 0.84, p < 0.01). Private insurance was protective against postoperative HAEC on univariate analysis (OR: 0.62, 95% CI: 0.38, 0.99, p = 0.047), but not on multivariate analysis (OR: 0.62, 95% CI: 0.37, 1.04, p = 0.07). Preoperative HAEC was not associated with the development of postoperative HAEC.

CONCLUSION:  Patients with a rectosigmoid transition zone have less postoperative HAEC compared with patients with a more proximal transition zone. Multi-institutional collection of clinical information in patients with HD may allow for the identification of additional risk factors for HAEC and afford the opportunity to improve care.

Author List

Taylor MA, Bucher BT, Reeder RW, Avansino JR, Durham M, Calkins CM, Wood RJ, Levitt MA, Drake K, Rollins MD

Author

Casey Matthew Calkins MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Case-Control Studies
Child
Child, Preschool
Databases, Factual
Digestive System Surgical Procedures
Enterocolitis
Female
Hirschsprung Disease
Humans
Infant
Infant, Newborn
Logistic Models
Male
Postoperative Complications
Retrospective Studies
Risk Factors
Young Adult