EN
TÜRKÇE
Poster - 97
Surgical complications in hirschsprung disease and the ımpact of botulinum toxin ınjection on hirschsprung-associated enterocolitis
Fatma Özcan Sıkı, Mehmet Sarıkaya, Metin Gündüz, Tamer Sekmenli, Gamze Kaygısız Bayındır, İlhan Çiftçi
Selcuk University Faculty of Medicine, Department of Pediatric Surgery
Purpose: Hirschsprung disease (HD) is an enteric nervous system anomaly that requires long-term follow-up due to complications that develop after corrective surgery. In this study, the frequency of complications observed after surgery and the effectiveness of Botulinum Toxin Injection (BTI) in managing Hirschsprung-associated enterocolitis (HIEA) attacks following surgery were evaluated.
Method: A retrospective examination was conducted on 72 patients who underwent corrective surgery for the diagnosis of HD in our clinic between 2011 and 2023. Demographic characteristics of the patients, applied surgical techniques, postoperative complications, and BTI applications were analyzed.
Results: 83.3% of the patients were male and 16.7% were female. The mean age at diagnosis was 11 months, and the mean age at surgery was 23 months. The most commonly applied surgical method was the Duhamel procedure (%77,7), followed by Swenson and endorectal pull-through procedures. Anastomotic leakage was seen in 8.9% of Duhamel and 25% of Swenson. HIEA was observed in 21.4% of Duhamel patients and 25% of Swenson patients. No complications were observed in patients who underwent endorectal pull-through. Enterocolitis attacks regressed in 11 of 13 patients (84.6%) who underwent BTI. 78.2% of patients who developed complications had long-segment HD.
Conclusion: The management of complications developing in patients undergoing corrective surgery for Hirschsprung disease varies according to the surgical technique. The lower complication rates of the Duhamel procedure and the successful control of HIEA attacks by BTI increase the preference for these methods. It is thought that BTI may be an effective and reliable option in the management of HIEA. These findings should be supported by forward-looking, prospective, and more comprehensive studies.