Follow-Up Studies in 50 Totally Colectomised Children

Kraeft, H; Am, Holschneider; Wc, Hecker; Burger, Dominik; Knutrud, O; Menardi, G; Mothes, Walther; Rode, H.; Schickedanz, H; Stirrat, A

doi:10.1055/s-2008-1059721

Cited by 4 publications

(4 citation statements)

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“…Our results show that even anterior resection may come up with good results in the treatment of long segment neuronal malformations. Therefore performing a pouch procedure is not necessarily superior to this technique (3,5,7,14).…”

Section: Discussionmentioning

confidence: 99%

Results of Total and Subtotal Colon Resections in Children

Dübbers

Am²,

Meier‐Ruge³

2003

Eur J Pediatr Surg

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Our findings showed that the surgical treatment with Rehbein's technique offers good results, both with respect to complications as well as to the postoperative course, although a 4 cm long aganglionic segment remains in situ. We found that results were better after ascendorectostomy (n = 22) compared to ileorectostomy (n = 11). Earlier publications of this group (13) show that the histology of the proximal resection margin is decisive for the prognosis. Hypo- and aganglionic segments should be completely resected while short IND segments of the colon or terminal ileum may remain in situ. However, the additional effect of the aganglionic segment of the distal rectum and the decreased peristaltic flow of the pre-anastomotic bowel has to be taken into account. Further investigations are required to find out whether a combination of Soave's endorectal pull-through with a remaining neuronal dysplastic segment proximal to the resection margin may give better results or if the frequency of postoperative enterocolitis and incontinence increased in cases of long segment intestinal neuronal malformations. Accurate diagnosis of myenteric plexus is decisive for an optimal treatment and therefore, considering our results, it is essential that in case of newborns getting to hospital with colon obstruction and suspicion of neuronal intestinal malformation full thickness biopsies from the distal and proximal colon may be taken simultaneously with the enterostomy. Generally ileostomy is performed in patients suspected of long-segment neuronal intestinal malformations. Mucosa suction biopsies from the distal and proximal stoma side are less informative compared to full thickness biopsies.

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Section: Discussionmentioning

confidence: 99%

Results of Total and Subtotal Colon Resections in Children

Dübbers

Am²,

Meier‐Ruge³

2003

Eur J Pediatr Surg

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“…Für sämtliche Laborwerte werden die Mediane sowie die 2-Sigmabereiche angegeben. In der Gruppe der total colektomierten Kinder fanden sich für Renin mit 5,2; 2,7-6,8 ng/ml' h (Normalwerte = NW 1,3; 0,5-4,0 ng/ml' h) und Aldosteron mit 242,1 (168,4- (23,24) beschrieben colektomierte Kinder, die hinsichtlich ihrer Größe im unteren Perzentilenbereich lagen. Vier VDn 50 colektomierten Kindern, die durchschnittlich 5 '/2 Jahre nach der Colektomie untersucht worden waren, lagen hinsichtlich ihrer Länge unter der 3.…”

Section: Klinische Untersuchungenunclassified

Spätergebnisse nach partieller und totaler Colektomie im Säuglingsalter

Teufel

Kleeberg²,

Flach³

et al. 1988

Klin Padiatr

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26 children were investigated on an average 11.5 years after partial (n = 13) and total (n = 13) colonic resection. Total colectomy was followed by an increased frequency of gastrointestinal symptoms such as recurrent abdominal pain, flatulence, attacks of diarrhoea, frequent and pasty or liquid stools with strange smell. An increased salt or fluid intake was observed in one half of these patients. Their height and bone age was slightly but significantly reduced. Laboratory investigations revealed no significant deficiencies of electrolyts, vitamins or trace elements. However Renin (mean and 2s-range = 5.2; 2.7-6.8 ng/ml.h, normal values (NV) 1.3; 0.5-4.0 ng/ml.h, p less than 0.02), aldosterone (242.1; 168.4-357.8 pg/ml, NV 78.9; 39.4-168.4 pg/ml, *p less than 0.02), conjugated bile acids (11.3; 5.2-20.0 mumol/1, NV 4.2; 1.5-7.0 mumol/1, p less than 0.01) and serum urea concentration (32.5; 20.8-48.7 mg/dl, NV 14.6; 6.0-22.5 mg/dl, p less than 0.01) were significantly elevated. Three postprandial plasma levels of gastrin, VIP and neurotensin were within normal limits. In patients with partial large bowel resection all signs were less pronounced. According to our results a special diet in children years after colectomy seems not to be required.

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“…In a follow-up study of 50 children with total colectomy, most of whom suffered from Hirschsprung disease, 14 children developed severe enteritis, and the most common pathogen was Salmonella (isolated in four children). 5 A history of intestinal and colorectal resection may be associated with this rare bacteremia case due to salmonellosis.…”

mentioning

confidence: 94%

“…The most potent risks for NTS bacteremia include extreme age and immunosuppressive status 1 ; however, the present patient was a 6‐year‐old child who had been immunocompetent since the neonatal period. In a follow‐up study of 50 children with total colectomy, most of whom suffered from Hirschsprung disease, 14 children developed severe enteritis, and the most common pathogen was Salmonella (isolated in four children) 5 . A history of intestinal and colorectal resection may be associated with this rare bacteremia case due to salmonellosis.…”

mentioning

confidence: 99%

Salmonella enterica Jangwani bacteremia in a totally colectomized child

Wada,

Matsubara,

Naito

et al. 2023

Pediatrics International

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Follow-Up Studies in 50 Totally Colectomised Children

Cited by 4 publications

References 0 publications

Results of Total and Subtotal Colon Resections in Children

Results of Total and Subtotal Colon Resections in Children

Spätergebnisse nach partieller und totaler Colektomie im Säuglingsalter

Salmonella enterica Jangwani bacteremia in a totally colectomized child

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