Physician Niels Bjørn Department of Surgery, Odense University Hospital
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Effekten af postoperativ peroral antibiotika efter rektal biopsi i udredning for Mb. Hirschsprung.
Hirschsprungs Disease is diagnosed by a biopsy from the rectum and a histopathologic demonstration of absence of enteric ganglion cells in the distal rectum along with hypertrophic nerve fibres. When performing the biopsy there is a risk of complications of 5%. We will examine whether postoperative prophylactic antibiotics to this group of patients will reduce the rate of complications.
Hirschsprung disease (HD) is a congenital disease afflicting approximately 1/5000 new-borns and should be considered when late passing of meconium or severe constipation is present. The disease is caused by the lack of ganglia cells in the myenteric plexus (Auerbach plexus) and the submucosal plexus (Meissner plexus) in colonintestines. In approximately 80 % of the cases the disease is located to the rectosigmoid colon, less frequently is the remaining sigmoideum or colon involved, and rarely the aganglionosis extends to the small bowels.
HD is diagnosed by a biopsy from the rectum and a histopathologic demonstration of absence of enteric ganglion cells in the distal rectum along with hypertrophic nerve fibres. Biopsies can be obtained in a number of ways, e.g.by two methods full-thickness rectal biopsy (FTB) or rectal suction biopsy (RSB).
In a former study conducted by our research group we found a rate of complications of 5.9 % when using FTB without prophylactic antibiotics. In other studies, the rate of complications varies from 0-15% 4-7. The most common complications are post-operative fever or episodes of pain, and among these 1/3 were treated with antibiotics. Less than 1% had more severe complications that required procedures done in general anaesthesia (GA).
No former studies have examined whether prophylactic postoperative prophylactic antibiotics to this group of patients will reduce the rate of complications.
The aim of this study was to examine the rate of complications after FTB in GA, when giving peri- and post-operative oral antibiotics to children under the age of 1.
Description of the cohort
Children with late passing of meconium or severe constipation.