Abstract：
BACKGROUND: The aim of this study was to assess long-term outcomes of neonatal patients with Hirschsprung disease (HD) after single-stage transanal endorectal pull-through (TEPT) and to explore the predictive factors contributing to subnormal bowel function.
METHODS: Patients aged > 3 years operated for HD with TEPT during neonatal period between 2007 and 2019 answered the bowel function score (BFS) questionnaire. The patients were retrospectively divided into two groups according to whether they had normal bowel function. The clinical variables were compared between the subnormal and normal BFS groups. Univariate and multivariable logistic regression analysis were performed to identify the predictive factors contributing to subnormal bowel function.
RESULTS: A total of 160 children (71.7%) were included in this study, with mean follow-up time of 7.3 years (range 3.0-15.1 years). The level of aganglionosis were determined to be the short-segment (124/160, 77.5%), long-segment (33/160, 20.6%), and TCA (3/160, 1.9%). One hundred and thirty-four patients (83.8%) had a BFS ≥ 17, and 26 patients (16.2%) with subnormal bowel function (BFS < 17). Univariate and multivariate logistic regression analysis showed that level of aganglionosis with long-segment or TCA and postoperative hospital stay > 8.5 days were independent risk factors with OR of 3.213 (1.252, 8.246) and 3.813 (1.371, 10.606) for subnormal BFS, respectively.
CONCLUSIONS: Most HD patients who underwent one-stage TEPT in the neonatal period have favorable long-term results, and the level of aganglionosis with long-segment or TCA and long postoperative hospital stay may be closely related to subnormal bowel function.
METHODS: Patients aged > 3 years operated for HD with TEPT during neonatal period between 2007 and 2019 answered the bowel function score (BFS) questionnaire. The patients were retrospectively divided into two groups according to whether they had normal bowel function. The clinical variables were compared between the subnormal and normal BFS groups. Univariate and multivariable logistic regression analysis were performed to identify the predictive factors contributing to subnormal bowel function.
RESULTS: A total of 160 children (71.7%) were included in this study, with mean follow-up time of 7.3 years (range 3.0-15.1 years). The level of aganglionosis were determined to be the short-segment (124/160, 77.5%), long-segment (33/160, 20.6%), and TCA (3/160, 1.9%). One hundred and thirty-four patients (83.8%) had a BFS ≥ 17, and 26 patients (16.2%) with subnormal bowel function (BFS < 17). Univariate and multivariate logistic regression analysis showed that level of aganglionosis with long-segment or TCA and postoperative hospital stay > 8.5 days were independent risk factors with OR of 3.213 (1.252, 8.246) and 3.813 (1.371, 10.606) for subnormal BFS, respectively.
CONCLUSIONS: Most HD patients who underwent one-stage TEPT in the neonatal period have favorable long-term results, and the level of aganglionosis with long-segment or TCA and long postoperative hospital stay may be closely related to subnormal bowel function.
摘要：
背景：本研究的目的是评估新生儿先天性巨结肠（HD）患者经单阶段经肛门直肠内穿刺（TEPT）后的长期结局，并探讨导致肠功能低于正常的预测因素。
方法：在2007年至2019年间，在新生儿期接受TEPTHD手术的年龄>3岁的患者回答了肠功能评分（BFS）问卷。根据患者肠功能是否正常将患者分为两组。比较亚正常和正常BFS组的临床变量。进行了单变量和多变量逻辑回归分析，以确定导致肠功能低于正常的预测因素。
结果：本研究共纳入160名儿童（71.7%），平均随访时间为7.3年（范围3.0-15.1年）。确定神经节病的水平为短节段（124/160，77.5％），长段（33/160，20.6%），和TCA（3/160，1.9%）。一百三十四名患者（83.8％）的BFS≥17，26名患者（16.2％）的肠功能低于正常（BFS<17）。单因素和多因素logistic回归分析显示，长节段或TCA水平和术后住院时间>8.5天是独立危险因素，低于正常BFS的OR为3.213（1.252，8.246）和3.813（1.371，10.606）。分别。
结论：大多数在新生儿期接受一期TEPT的HD患者具有良好的长期效果，长节段或TCA和术后住院时间长的神经节病水平可能与肠功能异常密切相关。
方法：在2007年至2019年间，在新生儿期接受TEPTHD手术的年龄>3岁的患者回答了肠功能评分（BFS）问卷。根据患者肠功能是否正常将患者分为两组。比较亚正常和正常BFS组的临床变量。进行了单变量和多变量逻辑回归分析，以确定导致肠功能低于正常的预测因素。
结果：本研究共纳入160名儿童（71.7%），平均随访时间为7.3年（范围3.0-15.1年）。确定神经节病的水平为短节段（124/160，77.5％），长段（33/160，20.6%），和TCA（3/160，1.9%）。一百三十四名患者（83.8％）的BFS≥17，26名患者（16.2％）的肠功能低于正常（BFS<17）。单因素和多因素logistic回归分析显示，长节段或TCA水平和术后住院时间>8.5天是独立危险因素，低于正常BFS的OR为3.213（1.252，8.246）和3.813（1.371，10.606）。分别。
结论：大多数在新生儿期接受一期TEPT的HD患者具有良好的长期效果，长节段或TCA和术后住院时间长的神经节病水平可能与肠功能异常密切相关。
