Wang Dajia,Zhang Zhibo,Bai Yuzuo.Unplanned readmissions of infants after pull-through for Hirschsprung disease[J].Journal of Clinical Pediatric Surgery,,20():217-221.[doi:10.12260/lcxewkzz.2021.03.004]
Unplanned readmissions of infants after pull-through for Hirschsprung disease
- CLC:
- R726.1;R574;R516.1
- Abstract:
- Objective To analyze unplanned readmissions of infants after pull-through for Hirschsprung disease (HSCR).Methods This retrospective cohort study was performed for 326 infants undergoing operations for Hirschsprung disease between October,2011 and September,2020.Clinical data,pathological type,approaches,readmission causes and readmission time were statistically analyzed. Results A total of 51 infants (15.6%) had an unplanned hospitalization after discharge.There were 271 boys and 55 girls with a mean operative age of (2.53±1.32) months.Fifty-one cases (15.6%) were readmitted for 64 times and 10 (19.6%) admitted multiple times.Time to readmission after discharge was as follows:28 infants (54.9%) were readmitted within 1 month after discharge,12 (23.5%) from 1 month to 1 year and 11 (21.6%) from 1 to 3 years.Readmission causes included enterocolitis infection (n=56,87.5%),intestinal obstruction (n=6,9.4%) and electrolyte disturbance (n=2,3.1%).Two patients (0.6%) underwent unplanned secondary surgery of lysis of intestinal adhesion (n=1) and laparoscopic subtotal colon resection and rotation of right colon (n=1) at Year 3 after pull-through.Prior to 2017,45/248 patients (18.1%) were admitted with longer muscle sheaths.From 2018 to 2020,6/78 patients (7.7%) returned to the hospital with shorter muscular sheaths.There was statistically significant difference (χ2=4.913,P=0.027). Conclusion Enterocolitis and intestinal obstruction are the major causes of readmission after pull-through in HSCR infants.Most readmissions occur within 1 month of surgery.Frequent follow-ups may reduce the incidence of early postoperative readmission.A shorter muscle sheath may reduce the postoperative incidence of enterocolitis and intestinal obstruction and lower the readmission rate.
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Memo
收稿日期:2021-01-15。
基金项目:辽宁省重点研发计划联合计划（编号：2020JH2/10300131）；辽宁省兴辽英才计划（编号：XLYC1908008）
通讯作者:王大佳,Email:wangdj@sj-hospital.org