Parahita IG, et al. – Authors here compared the Hirschsprung–associated enterocolitis (HAEC) frequency following the Soave and Duhamel procedures. They observed significantly higher frequency of HAEC after the Duhamel than the Soave procedure. In addition, patients with pre–operative enterocolitis seemed to be at risk of having HAEC following pull–through.

Methods

• Authors retrospectively analyzed medical records for patients who underwent the Soave and Duhamel pull-through at Dr. Sardjito Hospital, Indonesia from 2010 to 2015.
• Using a HAEC scoring system, they determined the diagnosis of HAEC.

Results

• One hundred patients were involved (Soave: 52 males and 19 females vs. Duhamel: 23 males and 6 females, p = 0.62).
• Findings suggested marked difference in mean age at pull-through (Soave: 29.9 ± 45.2 vs. Duhamel: 50.8 ± 47.5 months, p = 0.04), whereas mean age of HSCR diagnosis and pre-operative enterocolitis frequency did not differ significantly between groups (Soave: 25.4 ± 41.0 vs. Duhamel: 43.7 ± 48.1 months, p = 0.06, and Soave: 7% vs. Duhamel: 14%, p = 0.44, respectively).
• Significantly higher HAEC frequency was observed after pull-through in the Duhamel than the Soave group (28% vs. 10%, respectively, p = 0.03).
• Furthermore, pre-operative enterocolitis indicated a significant association with HAEC following pull-through (p = 2.0 × 10^–4) and the risk of HAEC after Soave pull-through was greater in long-segment aganglionosis compared to short-segment HSCR (p = 0.015).