Functional outcomes in Hirschsprung disease patients after transabdominal Soave and Duhamel procedures.

Functional outcomes in Hirschsprung disease patients after transabdominal Soave and Duhamel procedures.
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DOI:
10.1186/s12876-018-0783-1
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发表时间:
2018-04-27
影响因子:
2.4
通讯作者:
Gunadi
Gunadi
中科院分区:
医学4区
文献类型:
--
作者:
Widyasari A;Pavitasari WA;Dwihantoro A;Gunadi

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已经描述了几种针对先天性巨结肠症 (HSCR) 的拉通手术,具有不同的功能结果。自主排便 (VBM) 以及拉出后没有排便或便秘仍然是良好结果的最重要标志。我们的目的是比较 Soave 和 Duhamel 手术后 HSCR 患者的功能结果。 Krickenbeck 分类用于确定 2013 年至 2016 年在印度尼西亚 Sardjito 博士医院接受 Soave 和 Duhamel 拉穿术的患者的 VBM、排泄和便秘。共确定了 53 名患者(Soave:23 名男性和 2 名女性,而 Duhamel:22 名男性和 6 名女性,p = 0.26)。 Duhamel 和 Soave 拉通后,分别有 93% 和 88% 的患者出现 VBM(p = 0.66)。 Soave 组的便秘频率显着高于 Duhamel 组(24% vs. 4%;p = 0.04),OR 为 8.5 (95% CI = 1.0–76.7),而 Duhamel (21%) 和 Soave (8%) 组之间的便秘率相似 (p = 0.26)。此外,Soave 手术后女性患者的便秘风险增加了约 21.7 倍,并且几乎具有统计学显着性 (p = 0.05)。接受 Soave 手术的患者便秘率高于 Duhamel 手术患者,但 VBM 和排便频率相似。女性可能会增加 Soave 拉通后的便秘风险。此外,有必要进行更大样本患者的多中心研究来澄清和证实我们的研究结果。
Several pull-through procedures have been described for Hirschsprung disease (HSCR) with varying functional outcomes. The voluntary bowel movement (VBM) and the absence of soiling or constipation after pull-through remain the most important markers of good outcome. We aimed to compare the functional outcomes in HSCR patients following Soave and Duhamel procedures. Krickenbeck classification was utilized to determine VBM, soiling and constipation for patients who underwent Soave and Duhamel pull-through at Dr. Sardjito Hospital, Indonesia from 2013 to 2016. Fifty-three patients were ascertained (Soave: 23 males and 2 females vs. Duhamel: 22 males and 6 females, p = 0.26). Ninety-three and 88% patients had a VBM following Duhamel and Soave pull-through, respectively (p = 0.66). Constipation frequency was significantly higher in Soave than Duhamel groups (24% vs. 4%; p = 0.04) with OR of 8.5 (95% CI = 1.0–76.7), whereas soiling rate was similar between Duhamel (21%) and Soave (8%) groups (p = 0.26). Furthermore, the risk of constipation was increased ~ 21.7-fold in female patients after Soave procedure and was almost statistically significant (p = 0.05). The constipation rate is higher in patients who underwent Soave than Duhamel procedure, but the VBM and soiling frequencies are similar. The constipation risk following Soave pull-through might be increased by the female gender. Furthermore, a multicenter study with a larger sample of patients is necessary to clarify and confirm our findings.
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期刊: BMC SURGERY
影响因子: 1.9
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