Abstract：
BACKGROUND: Pull-through procedures for Hirschsprung disease (HD) can be performed during the Neonatal Intensive Care Unit (NICU) stay or delayed until discharge following home irrigations. This study assesses the safety of a delayed pull-through as an alternative to neonatal reconstruction in infants with successful abdomen decompression with home irrigations based on Hirschsprung-associated enterocolitis (HAEC) development.
METHODS: A single-institution retrospective review of neonates with HD who underwent delayed or neonatal pull-through from July 2018-July 2022. Endpoints included post-pull-through HAEC incidence, recurrence at an 18-month follow-up, time to the first HAEC episode, NICU length of stay (LOS), and HAEC-related LOS.
RESULTS: Twenty-four neonates were included. Eighteen were discharged from the NICU with home irrigations. Of these, 3 (28%) developed enterocolitis preoperatively, 12 (67%) underwent a delayed pull-through. NICU LOS in the delayed cohort was 3 times shorter than in the neonatal (6 vs. 18 days, p < 0.01). The incidence of enterocolitis (82% vs. 80%), time to the first episode (43 vs. 57 days), and HAEC-related LOS (median of 3 days) were similar.
CONCLUSIONS: Delayed HD pull-through is a viable neonatal reconstruction alternative that reduces NICU stay without increasing the risk of postoperative HAEC development.
METHODS: Original Research Article.
METHODS: III.
METHODS: A single-institution retrospective review of neonates with HD who underwent delayed or neonatal pull-through from July 2018-July 2022. Endpoints included post-pull-through HAEC incidence, recurrence at an 18-month follow-up, time to the first HAEC episode, NICU length of stay (LOS), and HAEC-related LOS.
RESULTS: Twenty-four neonates were included. Eighteen were discharged from the NICU with home irrigations. Of these, 3 (28%) developed enterocolitis preoperatively, 12 (67%) underwent a delayed pull-through. NICU LOS in the delayed cohort was 3 times shorter than in the neonatal (6 vs. 18 days, p < 0.01). The incidence of enterocolitis (82% vs. 80%), time to the first episode (43 vs. 57 days), and HAEC-related LOS (median of 3 days) were similar.
CONCLUSIONS: Delayed HD pull-through is a viable neonatal reconstruction alternative that reduces NICU stay without increasing the risk of postoperative HAEC development.
METHODS: Original Research Article.
METHODS: III.
摘要：
背景：可以在新生儿重症监护病房（NICU）住院期间或延迟到家庭冲洗后出院进行Hirschsprung病（HD）的穿刺程序。这项研究评估了基于Hirschsprung相关小肠结肠炎（HAEC）发展的成功腹部减压并进行家庭灌溉的婴儿的延迟拉拔作为新生儿重建的替代方法的安全性。
方法：对2018年7月至2022年7月接受延迟或新生儿拉拔的HD新生儿进行单机构回顾性研究。终点包括牵拉后HAEC发生率，在18个月的随访中复发，到第一次HEC发作的时间，NICU住院时间(LOS),和HAEC相关的LOS。
结果：纳入24例新生儿。18人通过家庭灌溉从NICU出院。其中,3人（28%）术前发生小肠结肠炎，12人(67%)接受了延迟拉拔。延迟队列中的NICULOS比新生儿短3倍（6vs.18天,p<0.01)。小肠结肠炎的发病率(82%vs.80%),时间到第一集（43vs.57天），与HAEC相关的LOS(中位数为3天)相似.
结论：延迟HD牵拉是一种可行的新生儿重建替代方案，可在不增加术后HAEC发展风险的情况下减少NICU停留时间。
方法：原始研究文章。
方法：III.
方法：对2018年7月至2022年7月接受延迟或新生儿拉拔的HD新生儿进行单机构回顾性研究。终点包括牵拉后HAEC发生率，在18个月的随访中复发，到第一次HEC发作的时间，NICU住院时间(LOS),和HAEC相关的LOS。
结果：纳入24例新生儿。18人通过家庭灌溉从NICU出院。其中,3人（28%）术前发生小肠结肠炎，12人(67%)接受了延迟拉拔。延迟队列中的NICULOS比新生儿短3倍（6vs.18天,p<0.01)。小肠结肠炎的发病率(82%vs.80%),时间到第一集（43vs.57天），与HAEC相关的LOS(中位数为3天)相似.
结论：延迟HD牵拉是一种可行的新生儿重建替代方案，可在不增加术后HAEC发展风险的情况下减少NICU停留时间。
方法：原始研究文章。
方法：III.
