Clinical characteristics and influence of postoperative Hirschsprung-associated enterocolitis: retrospective study at a tertiary children’s hospital
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In brief
In brief
This retrospective study of 304 Hirschsprung's disease patients found that early postoperative enterocolitis (within 3 months) and recurrent episodes significantly impair nutritional status, bowel function, and quality of life. Key risk factors include preoperative malnutrition, long-segment disease, and severe early postoperative complications.
- Post-HAEC occurs in 30% of patients; early episodes (within 3 months) and recurrent episodes (≥3 in 6 months) significantly worsen nutrition, defecation, and quality of life.
- Early HAEC risk factors: preoperative undernutrition, long-segment disease, and severe postoperative complications (Grade 3-4 within 30 days).
- Recurrent HAEC adds non-parental caregivers as an independent risk factor beyond malnutrition, long-segment disease, and severe early complications.
- Timing and frequency of post-HAEC episodes matter clinically—classification by first episode timing and recurrence frequency aids prognostication and surveillance planning.
- Optimizing preoperative nutrition and minimizing severe early postoperative complications may reduce both early and recurrent HAEC risk.
Written by the GCMD Library team from the article.
Abstract
Purpose
To explore the influence of postoperative Hirschsprung-associated enterocolitis (post-HAEC) on long-term outcomes and to identify risk factors of post-HAEC.
Methods
The medical records of 304 eligible patients diagnosed with Hirschsprung’s disease (HSCR) were reviewed. We analyzed the clinical characteristics of post-HAEC and its influence on long-term outcomes. Furthermore, risk factors for early and recurrent HAEC were identified separately.
Results
The overall incidence of post-HAEC was 29.9% (91/304). We categorized early HAEC as occurring within postoperative 3 months (n = 39) and recurrent HAEC as occurring ≥ 3 episodes within postoperative 6 months (n = 25). Patients with early HAEC were more likely to experience worse nutritional status, defecation function, and quality of life compared to those with late or no episodes (P < 0.05). Similarly, the adverse influences of recurrent HAEC on these outcomes were also significant (P < 0.05). The risk factors for early HAEC included preoperative undernutrition, long-segment HSCR, and postoperative Grade 3–4 complications within 30 days. For recurrent HAEC, risk factors were preoperative malnutrition, non-parental caregivers, long-segment HSCR, and postoperative Grade 3–4 complications within 30 days.
Conclusion
Classification of post-HAEC based on the first episode time and frequency was necessary. The earlier or more frequent episodes of post-HAEC have detrimental influences on long-term outcomes. Furthermore, risk factors for early and recurrent HAEC were different.