Yenidoğan Hirschsprung Hastalığında Preoperatif Dönem Semptomatik Olma Süresinin Tedavi Sonuçları Üzerine Etkisi

Öz

Amaç: Hirschsprung hastalığının yenidoğanlardaki preoperatif dönemde semptomatik olma süresinin tedavi sonuçları üzerine olan etkisinin araştırılmasıdır. Yöntem: Çalışmaya Ocak 2014-Ocak 2024 tarihleri arasında Mersin Üniversitesi Tıp Fakültesi Hastanesi Yenidoğan Yoğun Bakım ünitesinde Hirschsprung hastalığı nedeni ile tedavi edilen ve kolostomi açılan 15 hasta dahil edildi. Hastaların preoperatif klinik durumları, kolostomi açılma yaşları (= preoperatif dönem izlem süresi), kısa ve uzun segment Hirschsprung hastalığı olma durumları, postoperatif komplikasyonları kaydedildi. Hastaların kolostomi açılma yaşları, preoperatif klinik özelliklerine ve postoperatif komplikasyon durumlarına göre analiz edildi. Bulgular: Ortalama kolostomi açılma yaşı preoperatif dönemde intestinal pasaj sorunu (n=6), ileus (n=8) veya intestinal perforasyon (n=1) deneyimleyen hastalarda istatistiksel farklılık göstermedi (p=0.597). Postoperatif komplikasyon gelişen hastaların (n=6) ortalama kolostomi açılma yaşı, postoperatif komplikasyon gelişmeyen hastalara (n=9) göre daha büyük saptandı (88.8±8.3 güne karşılık 28.1±9.1 gün, p<0.001). Sonuç: Yenidoğan Hirschsprung hastalığında nonspesifik bulgular ayırıcı tanı konusunda güçlükler oluşturmakta ve bu durum tanı ve tedavi süreçlerini uzatıp beraberinde morbiditeyi arttırmaktadır. Bu nedenle yenidoğanlarda intestinal pasaj sorunlarının yönetiminde süreç zamanlaması ile postoperatif komplikasyonlar arasındaki olası ilişkinin dikkate alınmalıdır.

Anahtar Kelimeler

• Hirschsprung hastalığı
• yenidoğan
• komplikasyon

The Impact of the Duration of Preoperative Symptomatic Period on Treatment Outcomes in Neonatal Hirschsprung's Disease

Öz

Aim: To investigate the effect of the duration of symptomatic period in the preoperative phase of Hirschsprung's disease on treatment outcomes in newborns. Methods: A retrospective study was conducted on 15 neonates diagnosed with Hirschsprung's disease and who underwent colostomy at Mersin University Faculty of Medicine Hospital between January 2014 and January 2024. Patient data including preoperative clinical status, age at colostomy (serving as a proxy for preoperative symptom duration), presence of short-segment or long-segment disease, and postoperative complications were collected. The primary objective was to investigate the correlation between age at colostomy and preoperative clinical features, as well as postoperative outcomes. Results: There was no statistically significant difference in the mean age at colostomy among patients presenting with preoperative intestinal passage problems (n=6), ileus (n=8), or perforation (n=1) (p=0.597). However, patients who developed postoperative complications (n=6) had a significantly higher mean age at colostomy compared to those without complications (n=9) (88.8±8.3 days vs. 28.1±9.1 days, p<0.001). Conclusion: The nonspecific nature of presenting symptoms in neonates with Hirschsprung's disease poses challenges in differential diagnosis, often leading to delays in diagnosis and treatment, thereby increasing morbidity. Consequently, the possible relationship between the onset of intestinal passage problems and the development of postoperative complications should be taken into consideration in the management of intestinal passage problems in newborns.

Anahtar Kelimeler

• Hirschsprung disease
• newborn
• complication

Kaynakça

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