Incidence of Infection-related Complications and Optimal Saline Irrigation Volume for Preoperative Bowel Preparation to Reduce Postoperative Infections in Hirschsprung’s Disease

Authors

  • Ravit Ruangtrakool Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Bangkok 10700, Thailand
  • Sasabong Tiyaamornwong Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand

DOI:

https://doi.org/10.33192/smj.v75i11.264260

Keywords:

Hirschsprung, endorectal pullthrough, complications, irrigation, bowel preparation

Abstract

Objective: The purpose of this study was to find incidence of infection-related complications and the optimal volume and duration (days) of rectal NSS irrigation that would result in the low post-operative complications following transanal endorectal pull-through (TERPT) in patients with Hirschprung’s disease.

Materials and Methods: We conducted a retrospective chart reviews of 131 patients diagnosed with Hirschsprung’s disease who underwent TERPT at Siriraj Hospital between January 2006 and December 2020.

Results:  Infection-related complications were observed in 23(17.6%) patients, comprising 22(16.8%) cases of anastomotic strictures, 3(2.3%) cases of anastomotic leakages, and 2(1.5%) cases of intraabdominal collections. The median (Q1, Q3) volume of NSS irrigation (ml/kg/day) for those without complications (38.1 (33.9,50)) and those with complications (39.5 (35,45)) was statistically identical (p = 0.945). Similary, the median duration of for both groups was the same (p = 0.854). The mean (SD) volume of irrigated NSS in those with leakage (55.6 (32.7)) and those without leakage (44.3 (17.9)) showed no statistically significant difference (p = 0.291). Patients with post-operative stricture received the same amount of irrigated NSS (40.7 (11.9)) as those without stricture (45.4 (19.2)) (p = 0.138). Similarly, those with hyponatremia received the same amount of irrigated NSS as those without hyponatrema (p = 0.475).

Conclusion: The volume of rectally irrigated NSS did not correlate with infection-related complications such as anastomotic leakage, stricture and intraabdominal collection. However, this study observed a low complication rate, thus, future research should cover a larger population.

References

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Incidence of Infection-related Complications and Optimal Saline Irrigation Volume for Preoperative Bowel Preparation to Reduce Postoperative Infections in Hirschsprung’s Disease

Published

01-11-2023

How to Cite

Ruangtrakool, R., & Tiyaamornwong, S. . (2023). Incidence of Infection-related Complications and Optimal Saline Irrigation Volume for Preoperative Bowel Preparation to Reduce Postoperative Infections in Hirschsprung’s Disease. Siriraj Medical Journal, 75(11), 763–769. https://doi.org/10.33192/smj.v75i11.264260

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