Impact of rectal dissection technique on primary-school-age outcomes for a British and Irish cohort of children with Hirschsprung disease
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · May 2022 · 1 min read
In brief
In brief
This prospective cohort study of 277 British and Irish children with Hirschsprung disease compared long-term outcomes across three surgical techniques (Soave, Duhamel, Swenson) at primary school age. The Swenson procedure showed significantly higher unplanned reoperation rates compared to Soave, with important implications for surgical technique selection in HD management.
Written by the GCMD Library team from the article.
Background: This prospective cohort study compared primary-school-aged outcomes between children with Hirschsprung disease (HD) following Soave, Duhamel or Swenson procedures.
Methods: Children with histologically proven HD were identified in British/Irish paediatric surgical centres (01/10/2010-30/09/2012). Parent/clinician outcomes were collected when children were 5-8 years old and combined with management/early outcomes data. Propensity score/covariate adjusted multiple-event-Cox and multivariable logistic regression analyses were used.
Results: 277 (91%) of 305 children underwent a pull-through (53% Soave, 37% Duhamel, 9% Swenson). Based upon 259 children (94%) with complete operative data, unplanned reoperation rates (95% CI) per-person year of follow-up were 0.11 (0.08-0.13), 0.34 (0.29-0.40) and 1.06 (0.86-1.31) in the Soave/Duhamel/Swenson groups respectively. Adjusted Hazard Ratios for unplanned reoperation compared with the Soave were 1.50 (95% CI 0.66-3.44, p=0.335) and 7.57 (95% CI 3.39-16.93, p