Hipoalbuminemia prabedah sebagai faktor prognostik enterokolitis pascabedah penderita megakolon kongenital (Hirschsprung’s disease)

Rochadi Rochadi

doi:10.22146/ijcn.15443

Hipoalbuminemia prabedah sebagai faktor prognostik enterokolitis pascabedah penderita megakolon kongenital (Hirschsprung’s disease)

https://doi.org/10.22146/ijcn.15443

Rochadi Rochadi^(1*)

(1) Bagian Bedah Anak, Rumah Sakit Umum Pusat Dr. Sardjito
(*) Corresponding Author

Abstract

Background: Hirschsprung’s disease or congenital megacolon is the congenital absence of ganglion cells in the colon. The rectum is always involved and in 90% of patients the abnormality is confined to the rectum and sigmoid. Absence of ganglion cells prevents peristalsis, resulting in functional obstruction. The success of Hirschsprung’s treatment depends on many factors such as age at the time of operation, body weight, hemoglobin levels, albumin levels, length of operation, length of stay and other prognostic factors. Post operative enterocolitis and other complications still represent as the problem wich often are faced by pediatric surgeons.

Objective: The aim of this study was to evaluate the effect of albumin levels on postoperative enterocolitis in children presenting with congenital megacolon.

Method: We conducted an ambidirectional cohort study involving children presenting with Hirschsprung’s disease in Dr. Sardjito, Panti Rapih and Permata Husada hospitals in Yogyakarta city from January 2005 to December 2010. All children had been operated using ERPT and PSNRHD methods. The subjects were classified into normoalbuminemia (>3.5 g/dl) and hypoalbuminemia (≤3.5 g/dl). The effect of albumin levels on postoperative enterocolitis were indicated by relative risk and 95% confidence interval.

Results: Out of 104 children with Hirschsprung’s disease, 53 (51%) were hypoalbuminemic and 51 (49%) were normoalbuminemia. Postoperative enterocolitis was found in 18 (17.3%) children, 11/18 (61.1%) of them were hypoalbuminemia, whereas 7/18 (38.9%) were normoalbuminemia. Albumin levels were not significant prognostic factor for postoperative enterocolitis in children with congenital megacolon (RR=1.51; 95% CI:0.64-3.60; p=0.34).

Conclusion: The albumin levels are not prognostic factor for postoperative enterocolitis in children with congenital megacolon.

Keywords

postoperative enterocolitis; preoperative albumin level; congenital megacolon

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References

Teitelbaum DH, Wulkan ML, Georgeson KE, Langer JC. Hirschsprung’s disease. In: Operative pediatric surgery. Philadelphial: Mc-Graw – Hill Professional; 2003.

Kartono D. Penyakit Hirschsprung. Jakarta: Sagung Seto; 2004.

Ali KAE. Transanal endorectal pull-through for Hirschsprung’s disease during the first month of life. Annal Pediatr Surg 2010;6(2):81-8.

Estevao-Costa J, Fragoso AC, Campos M, Soares-Oliveira M, Carvalho JL. An approach to minimize postoperative enterocolitis in Hirschprung’s disease. J Pediatr Surg 2006;41(10):1704-07.

Leeuwen KV, Geiger JD, Barnett JL, Coran AG, Teitelbaum DH. Stooling and manometric finding after primary pull-through in Hirschsprung’s disease: perineal versus abdominal approaches. J Pediatr Surg 2002;37(9):1321-5.

El-Sawaf MI, Drongowski RA, Chamberlain JN, Coran AG, Teitelbaum DH. Are the long term results of the transanal pull-through equal to those of the transabdominal pull-through? A comparison of the 2 approaches for Hirschsprung disease. J Pediatr Surg 2007;42(1):41-7.

Surana R, Quinn FMJ, Puri P. Evaluation of risk factors in the development of enterocolitis complicating Hirschsprung’s disease. Pediatr Surg Int 1994;9(4):234-6.

Storey DW. Microbial studies of enterocolitis in Hirschsprung’s disease. Ped Surg Int 1994; 9(4):248-50.

Gibbs J, Cull W, Henderson W, Daley J, Hur K, Khuri FS. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. J Arch Surg 1999;134(1):36-42.

Langer JC. Hirschsprung’s disease in principles and practice of pediatric surgery. Philadelphia: Lippincott William & Wilkin; 2005.

Lemeshow S, Hosmer Jr DW, Klar J, Lwanga SK. Besar sampel dalam penelitian kesehatan. Pramono D. 1997 (Alih bahasa). Yogyakarta: UGM Press; 1997.

Niedringhaus L. Hypovolemic shock in shock comprehensive nursing management. London: Mosby Company; 1983.

Teitelbaum DH, Cilley RE, Sherman NJ, Biiss D, Uitvlugt ND, Renaud EJ, Kirstioglu I, Bengston T, Coran AG. A decade of experience with the primary pull-through for Hirschsprung disease in the newborn period: a multicenter analysis of outcomes. Ann Surg 2000;232(3):372-80.

Sieber WK. Hirschprung’s disease in pediatric surgery. London: Year Book Medical Publisher; 1986.

Guzzetta PC, Anderson KD, Altman RP, Newman KD, Eichelberger MR, Randolp J. Hirschsprung’s disease in principles of surgery. 5th ed. New York: McGraw-Hill Information Services Company; 1988.

Betts EK, Downes JJ. Anesthesia in pediatric surgery. London: Year Book Medical Publisher INC; 1986.

Soper RT. Abdominal pain in synopsis of pediatric surgery. Stuttgart: Georg Thieme Publishers; 1975.

Bernard R. Fundamentals of biostatistik. 2nd ed. Boston: Duxbury Press; 1986.

Holschneider A, Ure BM. Hirschsprung’s disease in pediatric surgery. Philadelphia: Elsevier Saunders; 2005.

Haricharan RN, Georgeson KE. Hirschsprung disease. Semin Pediatr Surg 2008;17(4):266-75.

Agarwala S, Bathnagar V, Mitra DK. Long-term follow-up of Hirschsprung’s disease: review of early and late complications. Indian Ped 1996;33(5):382-6.

Rodriguez DM, Cuadros MM, Ortega GA, Gallego MG, Ortiz MM, Gonzales MAM, Arenas SM. Cholesterol and serum albumin levels as predictor of cross infection, death, and length of hospital stay. Arch Surg 2002;137(7):805-12.

DOI: https://doi.org/10.22146/ijcn.15443