Optimal Timing for Soave Primary Pull-through in Short-Segment Hirschsprung Disease: A Meta-Analysis
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In brief
In brief
Meta-analysis of 780 infants evaluates optimal age for Soave endorectal pull-through in short-segment Hirschsprung disease. Infants under 2.5 months at surgery showed significantly higher rates of soiling, anastomotic stricture, and leak compared to older infants, suggesting delayed surgery may improve functional outcomes.
Written by the GCMD Library team from the article.
Background
The optimal age for endorectal pull-through (ERPT) surgery in infants with short-segment Hirschsprung disease varies, with a trend toward earlier surgery. However, it is unclear if the timing of surgery impacts functional outcomes. We undertook the present study to determine the optimal timing of ERPT in infants with short-segment Hirschsprung disease.
Methods
The NCBI PubMed database was searched for English-language manuscripts published between 2000-2019 analyzing functional outcomes for patient following the initial Soave ERPT for short-segment Hirschsprung disease. Raw data from these studies was obtained from the corresponding author for each manuscript. We combined data from these papers with our own institutional data and performed a meta-analysis.
Results
A total of 780 infants were included in our meta-analysis. Constipation occurred in 1.0-31.7%, soiling 1.3-26.0%, anastomotic stricture 0.0-14.6%, and anastomotic leak 0.0-3.4%. Regarding age at ERPT, younger infants at the time of initial corrective surgery had higher rates of soiling, stricture, and leak. On sub-group analysis, patients