Unexpected gap between intraoperative caliber change of the intestine and normoganglia in patients with intestinal aganglionosis
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Aug 2019 · 1 min read
In brief
In brief
Retrospective study comparing intestinal aganglionosis (IA) to total colonic aganglionosis (TCA) reveals IA patients face significantly higher stoma dysfunction rates (83% vs 0%) due to an unexpected 85cm gap between intraoperative caliber change and normoganglia. Findings emphasize careful stoma placement consideration in IA cases.
Written by the GCMD Library team from the article.
Abstract
Purpose
Intestinal aganglionosis (IA) is so rare that the entity remains unclear. The aim of the present study was to compare the outcomes of patients with IA and those with total colonic aganglionosis (TCA).
Methods
The hospital records were retrospectively reviewed from 1977 to 2018. Outcomes were analyzed for the IA group and the TCA group, including clinical presentation, initial management, and operative details.
Results
There were six patients were managed in IA (all male) and seven patients in TCA (4 male). The median age at the first operation was significantly younger in IA than TCA (2 days vs 24 days, p = 0.01). The gap between the intraoperative caliber change (CC) of the intestine and the initial stoma location was not significantly different (7.5 cm vs 12 cm, p = 0.61), but the rate of stoma dysfunction was significantly higher in IA (83% vs 0%, p = 0.005). The gap between the CC and the ganglionated bowel was significantly longer in IA (85 cm vs 10 cm, p = 0.003).
Conclusion
Patients with IA appear to have a high risk for stoma dysfunction after the first operation because of the unexpected gap between the CC and normoganglia. The initial location of the stoma requires careful consideration.