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Minerva Pediatrica 2019 Nov 05

DOI: 10.23736/S0026-4946.19.05593-2


language: English

Enterostomy-related complications in Hirschsprung’s disease in a single cohort

Michela C. WONG 1, 2 , Stefano AVANZINI 1, Manuela MOSCONI 1, Cinzia MAZZOLA 1, Serena ARRIGO 3, Angela PISTORIO 4, Girolamo MATTIOLI 1, 2

1 Pediatric Surgery Department, IRCCS, Istituto Giannina Gaslini, Genoa, Italy; 2 DINOGMI, University of Genoa, Genoa, Italy; 3 Pediatric Gastroenterology Unit, IRCCS, Istituto Giannina Gaslini, Genoa, Italy; 4 Epidemiology and Biostatistics Service, IRCCS, Istituto Giannina Gaslini, Genoa, Italy


BACKGROUND: Hirschsprung’s disease (HSCR) is a frequent cause of intestinal obstruction in children and may require an enterostomy. The study aims to describe the most common enterostomy-related complications in a series of patients treated in a single Center.
METHODS: A series of consecutive HSCR patients treated or followed-up at our Institution between January 1993 and December 2016 were included. Data about HSCR type, enterostomy site, duration and complications of the stoma were recorded.
RESULTS: 301 patients with HSCR were followed up. 61 had ultralong forms (TCSA/TIA), 21 had long forms (L-HSCR) and 219 had classic short forms (S-HSCR). One-hundred thirty seven patients required a stoma (100% of patients with TCSA/TIA, 66.7% with L-HSCR and 28.3% with S-HSCR). We observed 64 stoma-related complications: 36 major complications and 28 minor complications. Major complications occurred more often in long forms (P=0.037). The presence of an ileostomy was statistically associated with an increased rate of complications compared to colostomy. The longer the stoma was in site, the higher the complication rate was.
CONCLUSIONS: Long and ultra-long forms are associated with a longer duration of the stoma and to a major risk of stoma-related complications.

KEY WORDS: Hirschsprung’s disease; Aganglionosis; Enterostomies complications; Colostomies

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