Preoperative management comprising tube irrigation using a trans-anal indwelling tube for infants with hirschsprung disease can allow single-stage radical surgery
Yoichi Nakagawa,
Hiroo Uchida,
Akinari Hinoki,
Takahisa Tainaka,
Chiyoe Shirota,
Wataru Sumida,
Satoshi Makita,
Kazuki Yokota,
Hizuru Amano,
Akihiro Yasui,
Takuya Maeda,
Daiki Kato,
Yousuke Gohda
Affiliations
Yoichi Nakagawa
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine
Hiroo Uchida
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine
Akinari Hinoki
Department of Rare/Intractable Cancer Analysis Research, Nagoya University Graduate School of Medicine
Takahisa Tainaka
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine
Chiyoe Shirota
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine
Wataru Sumida
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine
Satoshi Makita
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine
Kazuki Yokota
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine
Hizuru Amano
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine
Akihiro Yasui
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine
Takuya Maeda
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine
Daiki Kato
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine
Yousuke Gohda
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine
Abstract Background Preoperative management of Hirschsprung’s disease (HD) is currently being conducted with the goal of performing single-stage radical surgery without ileostomy. Methods We retrospectively reviewed HD cases between 2013 and 2022, as well as their outcomes related to preoperative management. Results Thirty-nine patients with HD were included in this study, including short-segment HD (30 cases), long-segment HD (4 cases), and total colonic aganglionosis (5 cases). Among these 39 patients, 95% (37 of 39 patients) underwent single-stage radical surgery after management with glycerin enema use (n = 13), irrigation with tube insertion each time irrigation was performed (n = 13), and irrigation using a tube placed in the bowel (n = 11). Conclusions Preoperative management of patients with HD allowed for single-stage surgery of long-segment HD and total colonic aganglionosis. Cases that could be managed without performing an emergency enterostomy during the neonatal period were managed with irrigation until radical surgery was performed.
