The Analysis On The Reasons Of The Early-stage Unplanned Reoperation Of Hirschsprun,S Disease Performed The First Phase Of Radical Operation

Hirschsprung’s disease (HD) is a congenital absence of ganglion cells in the hindgut with variable distal bowel involvement, HD is a common pediatric digestive tract malformation, of which it is in the second place. Once diagnosed, the surgery is the only effective way to HD, in addition to the part of short segment type and extremely short segment type. So, its the surgical treatment of indications, its operation method choice, its postoperative complications of the prevention and control has been a important research field of clinical surgeons. Radical operation is given priority, colostomy is aided operation; radical operation is treated in different ways and to be mature. With the rapid development of medical technology in China in recent years, the first phase of radical operation is more inclined to given to children with HD; Its success rate is gradually increasing and the postoperative complications is gradually reducing. But no matter what kind of operation method. Some patients must been given to unplanned reoperation caused by various reasons during the postoperative. Regarding to the early-stage unplanned reoperation of HD performed the first phase of radical operation, major cases of HD was summarized and reported more in foreign countries, but less in China. To analyze and summarize the related factors and the immediate reasons for the early-stage unplanned reoperation of496cases of HD which was performed the first phase of radical operation in this paper, and mainly discusses the immediate reasons of the early-stage unplanned reoperation.ObjectiveTo research and discuss the related factors and the immediate reasons of unplanned early reoperation of Hirschsprun’s disease performed the first phase of radical operation, improve the operation level of Hirschsprun’s disease, efforts to reduce the rate of unplanned early reoperation.Materials and methodsCollect the496cases of Hirschsprung’s disease which were performed the first phase of radical operation and material integrity In department of Pediatric Surgery, Third Affiliated Hospital of Zhengzhou University in June2009to June2013. Among which, short segment type in111cases, common segment type in312cases, long segment type in73cases. Statistics on the related factors, the immediate reasons, the time interval, reoperation method for the early-stage unplanned reoperation. And the data for statistical analysis.Results1. The relationship between the general related factors for the early-stage unplanned reoperation and the early unplanned reoperation is as follow, difference of gender, age (whether age is more than8months), preoperative RTI is not statistically significant; difference of preoperative enterocolitis, anemia and hypoalbuminemia is statistically significant.2. Clinical classification and the difference in operation method of the first phase of radical operation (the via anus Soave,the improved Soave) is not statistically significant.3. These are496cases of clinical data in the study, Among which,12cases went through unplanned early reoperation,1case of postoperative death, the early-stage unplanned reoperation rate of Hirschsprun’s disease which was performed the first phase of radical operation was2.4%, the mortality rate of reoperation was8.3%. Reasons of the early-stage unplanned reoperation are as follows:1cases of drag the bowel torsion(8.3%);1cases of postoperative bleeding(8.3%);1cases of insufflate retraction(8.3%);1cases of internal hernia formation(8.3%);1cases of intestinal mucosa prolapse(8.3%);1cases of incision dehiscence(8.3%);2cases of adhesive ileus(16.6%);2cases of recurrent constipation(16.6%);2cases of enterocolitis(16.6%).Conclusions1. In cases of Hirschsprung’s disease performed the first phase of radical operation,the gender, age (whether age is more than8months), preoperative RTI, clinical classification, operation method of the first phase of radical operation has no obvious relation with unplanned early reoperation rate, and the unplanned early reoperation rate of the cases with preoperative enterocolitis, anemia and hypoalbuminemia is higher than not consolidators.2. The immediate reasons of the early-stage unplanned reoperation of Hirschsprun’s disease which was performed the first phase of radical operation mainly related to complication postoperative. It related to the basic characteristics of Hirschsprun’s disease and its operation method,also to the degree of familiar with operation,whether in strict accordance with the surgery, whether is reasonable to the choice of operation method and other factors.