Analysis of the causes of redo pull-through for recurrent constipation and the risk factors affecting the prognosis of the Hirschsprung’s disease: a single-center retrospective study and systematic review

Abstract Background Hirschsprung’s disease (HSCR) is a congenital gastrointestinal disorder. Pull-through (PT) surgery, the primary treatment, often leads to recurrent constipation. The causes of redo pull-through (redo-PT) for recurrent constipation remain unclear, with limited research on follow-u...

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Main Authors: Jun Xiao, Shimin Yang, Lei Xiang, Bo Qin, Jingyi You, Mei Dong, Youshan Xie, Xuan Zhang, Xuyong Chen, Zejian Li, Honglin Li, Jiexiong Feng
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Pediatrics
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Online Access:https://doi.org/10.1186/s12887-025-05680-y
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Summary:Abstract Background Hirschsprung’s disease (HSCR) is a congenital gastrointestinal disorder. Pull-through (PT) surgery, the primary treatment, often leads to recurrent constipation. The causes of redo pull-through (redo-PT) for recurrent constipation remain unclear, with limited research on follow-up outcomes and prognostic factors. Methods We searched “PubMed” and “Web of Science” for references using the title/abstract terms “Hirschsprung” and “Redo pull-through”. We enrolled patients from the literature review group and our retrospective group who underwent redo-PT for recurrent constipation. A comparative analysis was conducted between two groups based on the clinical information for redo-PT. Results A total of 360 cases were collected from the references (327 patients) and our center (33 patients). Recurrent aganglionosis (RA) and Mechanical Obstruction (MO) were the primary reasons for redo-PT, accounting for 52.50% and 36.67%, respectively. When comparing the causes of redo-PT between the literature group and our center group, RA accounted for 49.85% and 75.76%, while MO accounted for 49.85% and 21.21%, respectively. Prognostic outcomes of 31 patients from our center were analyzed, revealing no significant associations between postoperative complications and gender, age, causes of redo pull-through, or surgical approach (P > 0.05). Conclusions Recurrent constipation requiring redo-PT are predominantly caused by RA and MO. Gender, age, causes of redo pull-through, or surgical approach do not affect the prognosis of redo-PT. The laparoscopic approach demonstrated superior cosmetic outcomes compared to the laparotomy approach.
ISSN:1471-2431