Comparison of Outcomes between Two Surgical Techniques for Patients with Intestinal Neuronal Dysplasia

Abstract

Objective. Hirschsprung disease (HSCR) is a serious congenital intestinal disease with a prevalence of 1/5000. HSCR remains one of the most severe congenital malformations of the abdominal organs in children that require complex reconstructive surgery. This study is aimed at investigating the clinical analysis of ileal Santulli stoma and ileal double-lumen stoma in children diagnosed with intestinal neuronal dysplasia (IND). Methods. Retrospective analysis was performed on the children who were admitted to our hospital for intestinal obstruction from January 2014 to January 2019, underwent fistula operation and fistula closure operation, and were diagnosed with IND. According to the different modes of fistula, the children were divided into ileal Santulli stoma group and ileal double-lumen stoma group. The body weight of the children in the two groups during the second stage of fistula closure operation was compared. The number of hospitalizations due to enteritis and dehydration during the two operations was compared. Results. A total of 23 cases (12 males and 11 females) were included in this study, including 10 cases in the Santulli group and 13 cases in the ileal double-lumen stoma group. There were no significant differences in baseline data and fistula location between the two groups. Compared with the ileal double-lumen stoma group, the Santulli stoma group had significantly higher weight of fistula precursor ( P < 0.05 ), the interval between two operations was shorter ( P < 0.05 ), there is less hospitalization for enteritis and dehydration during the two operations ( P < 0.05 ), and there is less economic cost after fistula ( P < 0.05 ). Conclusion. The clinical effect of ileum Santulli fistula is significantly better than double-lumen ileum fistula, which is not only beneficial to the growth and development of children after the first fistula but also can shorten the time of fistula closure, reduce the incidence of dehydration, and reduce the economic burden of family members. Therefore, it is worthy of clinical promotion and application.

Association between Clinical and Histopathological Findings in Intestinal Neuronal Dysplasia Type B: An Advance towards Its Definition as a Disease

“…Conservative therapy is composed of changes in diet, laxatives, and enemas in cases of fecal retention [ 4 , 19 , 20 ]. Surgical treatment includes sphincterotomy, extensive surgical resection, or temporary colostomy [ 21 , 22 , 23 , 24 , 25 ]. The current recommendation is that patients with no complications receive conservative treatment [ 4 , 7 , 14 , 19 ].…”

“…On the other hand, histopathological changes compatible with the diagnosis of IND-B were found in the colon segments of 36 completely asymptomatic children [ 26 ]. Other studies have failed to demonstrate a direct correlation between histopathological findings, clinical symptoms, and radiological and manometric changes [ 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. Faced with these controversies, several authors do not consider IND-B as a true clinical entity but only as a histopathological alteration of the enteric nervous system that may or may not present symptoms [ 16 , 30 , 31 ].…”

Retracted: Comparison of Outcomes between Two Surgical Techniques for Patients with Intestinal Neuronal Dysplasia

“…This article has been retracted by Hindawi following an investigation undertaken by the publisher [ 1 ]. This investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process: Discrepancies in scope Discrepancies in the description of the research reported Discrepancies between the availability of data and the research described Inappropriate citations Incoherent, meaningless and/or irrelevant content included in the article Peer-review manipulation …”

“…This article has been retracted by Hindawi following an investigation undertaken by the publisher [1]. This investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process:…”