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Impact of Colorectal Nurse Specialist supervised parental administration of rectal washouts on Hirschsprung's disease outcomes: a retrospective review.
Banerjee, Debasish B; Appasawmy, Nalini; Caldwell, Stephen; Wade, Rachel L; Owen, Anthony; Patwardhan, Nitin; Eradi, Bala.
Afiliación
  • Banerjee DB; Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK.
  • Appasawmy N; Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK.
  • Caldwell S; Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK.
  • Wade RL; Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK.
  • Owen A; Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK.
  • Patwardhan N; Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK.
  • Eradi B; Department of Paediatric Surgery, Leicester Royal Infirmary (LRI), Infirmary Square, Leicester, LE1 5WW, UK. bala.eradi@nhs.net.
Pediatr Surg Int ; 40(1): 107, 2024 Apr 13.
Article en En | MEDLINE | ID: mdl-38615130
ABSTRACT

PURPOSE:

To highlight the utility of Colorectal Nurse Specialist (CNS) supervised parental administration of rectal washouts in the management of Hirschsprung's disease (HD).

METHODS:

Retrospective case note review of HD patients treated at a tertiary children's hospital in United Kingdom from January 2011 to December 2022. Data collected included demographics, complications, enterocolitis, obstructive symptoms and stomas. Primary pull-through (PT) is done 8-12 weeks after birth. Parental expertise in performing rectal washouts at home is ensured by our CNS team before and after PT.

RESULTS:

PT was completed in 69 of 74 HD patients. Rectal washouts were attempted on 63 patients before PT. Failure of rectal washout efficacy necessitated a stoma in four patients (6.4%). Of the 65 patients who had PT and stoma closed, three (4.5%) required a further stoma over a mean follow-up period of 57 months (Range 7-144 months). Two of these had intractable diarrhoea due to Total Colonic Aganglionosis (TCA). One patient (1.5%) had unmanageable obstructive symptoms requiring re-diversion. Hirschsprung-associated enterocolitis (HAEC) requiring hospital admission occurred in 14 patients (21%).

CONCLUSION:

Our stoma rates are lower compared to recent UK data. This could potentially be due to emphasis on parental ability to perform effective rectal washouts at home under CNS supervision.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Enterocolitis / Enfermeras Especialistas / Enfermedad de Hirschsprung Límite: Child / Humans Idioma: En Revista: Pediatr Surg Int Asunto de la revista: PEDIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Enterocolitis / Enfermeras Especialistas / Enfermedad de Hirschsprung Límite: Child / Humans Idioma: En Revista: Pediatr Surg Int Asunto de la revista: PEDIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Alemania