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.

IF 2 3区医学 Q2 PEDIATRICS

BMC Pediatrics Pub Date : 2025-04-22 DOI:10.1186/s12887-025-05680-y

Jun Xiao, Shimin Yang, Lei Xiang, Bo Qin, Jingyi You, Mei Dong, Youshan Xie, Xuan Zhang, Xuyong Chen, Zejian Li, Honglin Li, Jiexiong Feng

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引用次数: 0

Abstract

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.

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复发性便秘的原因分析及影响巨结肠病预后的危险因素：单中心回顾性研究和系统评价

背景：巨结肠病（HSCR）是一种先天性胃肠道疾病。拉通手术是主要的治疗方法，但经常导致复发性便秘。复发性便秘的原因仍不清楚，对随访结果和预后因素的研究有限。方法：我们使用标题/摘要术语“Hirschsprung”和“Redo pull-through”在PubMed和Web of Science中检索参考文献。我们从文献回顾组和回顾性组中招募了因复发性便秘而接受redo-PT治疗的患者。根据临床资料对两组进行比较分析。结果：从文献（327例）和本中心（33例）共收集病例360例。复发性神经节病（RA）和机械性梗阻（MO）是复位pt的主要原因，分别占52.50%和36.67%。比较文献组和我们中心组redo-PT的原因，RA占49.85%,75.76%，MO占49.85%,21.21%。我们对31例患者的预后结果进行了分析，发现术后并发症与性别、年龄、重拔通原因或手术方式无显著相关性（P < 0.05）。结论：复发性便秘需要redo- pt主要由RA和MO引起。性别、年龄、redo- pt的原因或手术方式不影响redo- pt的预后。与剖腹手术相比，腹腔镜手术显示出更好的美容效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Pediatrics PEDIATRICS-

CiteScore

3.70

自引率

4.20%

发文量

683

审稿时长

3-8 weeks

期刊介绍： BMC Pediatrics is an open access journal publishing peer-reviewed research articles in all aspects of health care in neonates, children and adolescents, as well as related molecular genetics, pathophysiology, and epidemiology.