Preoperative Nutritional Support Significantly Reduces Postoperative Enterocolitis in Children with Hirschsprung Disease: A Multicenter Randomized Controlled Trial

Introduction

Hirschsprung disease (HSCR) is a congenital disorder characterized by the absence of ganglion cells in the distal bowel, leading to functional intestinal obstruction. While surgical pull-through remains the definitive treatment, postoperative complications, particularly Hirschsprung-associated enterocolitis (HAEC), continue to pose a significant threat to pediatric patients. HAEC is the leading cause of morbidity and mortality in this population, with an incidence ranging from 17% to 50% post-surgery. Recent clinical observations have highlighted that preoperative undernutrition is prevalent among children with HSCR, potentially compromising the intestinal mucosal barrier and immune response. This multicenter randomized controlled trial (RCT) sought to determine whether targeted preoperative nutritional support could mitigate the risk of early postoperative HAEC.

Highlights