التفاصيل البيبلوغرافية
| العنوان: |
European Paediatric Surgeons' Association Survey on the Management of Hirschsprung Disease. |
| المؤلفون: |
Zani, Augusto, Eaton, Simon, Morini, Francesco, Puri, Prem, Rintala, Risto, van Heurn, Ernest, Lukac, Marija, Bagolan, Pietro, Kuebler, Joachim F., Friedmacher, Florian, Wijnen, Rene, Tovar, Juan A., Hoellwarth, Michael E., Pierro, Agostino, Heurn, Ernest van, EUPSA Network Office |
| المصدر: |
European Journal of Pediatric Surgery; 2017, Vol. 27 Issue 1, p96-101, 6p |
| مصطلحات موضوعية: |
HIRSCHSPRUNG'S disease, PEDIATRIC surgeons, NAD (Coenzyme), RECTUM biopsy, DIAGNOSIS, THERAPEUTICS, DIGESTIVE organ surgery, MEDICAL societies, MEDICAL specialties & specialists, PEDIATRICS, POSTOPERATIVE care, SURGERY practice |
| مصطلحات جغرافية: |
EUROPE |
| مستخلص: |
Aim This study aims to define patterns of Hirschsprung disease (HD) management. Methods An online questionnaire was sent to all European Paediatric Surgeons' Association (EUPSA) members. Results A total of 294 members (61 countries) answered (response rate: 61%).Diagnosis: All respondents perform rectal biopsies (61% rectal suction [RSBs], 39% open full-thickness), 96% contrast enema, and 31% anorectal manometry. At RSB, 17% take the most distal biopsy 1 cm above the dentate line, 34% take 2 cm, 30% take 3 cm, and 19% take > 3 cm. Rectal biopsy staining's are hematoxylin/eosin (77%), acetylcholinesterase (74%), calretinin (31%), S100 (2%), nicotinamide adenine dinucleotide-tetrazolium reductase (2%), succinate dehydrogenase (1%), and neuron-specific enolase (1%). A total of 85% respondents recognize entities including hypoganglionosis (69%), intestinal neuronal dysplasia (55%), and ultrashort segment HD (50%).Surgery: Pull-through (PT) is performed at diagnosis by 33% or delayed by 67% (4 months or > 5 kg). Awaiting definitive surgery, 77% perform rectal irrigations, 22% rectal dilatation/stimulations, and 33% perform a stoma. The preferred type of PT is the Soave approach (65%), performed with transanal technique by 70% respondents. If symptoms persist after PT, most opt for conservative approach (enemas/laxatives = 76%; botulinum toxin = 27%), 30% would redo the PT. Total colonic aganglionosis: PT is performed in neonates (4%), at 1 to 6 months (29%), 6 to 12 months (37%) or older (30%). If required, a stoma is sited in the ileum (31%), according to intraoperative biopsies (54%), macroscopic impression (13%), and radiology (2%). Duhamel PT is performed by 52%, Soave by 31%, and Swenson by 17%. Overall, 31% would perform a J-pouch. Conclusions Most aspects of HD management lack consensus with wide variations in obtaining a diagnosis. Transanal Soave PT is the most common technique in standard segment HD. Guidelines should be developed to avoid such variability in management and to facilitate research studies. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
