Surgical management and outcomes of total colonic aganglionosis in children: A systematic review and meta-analysis.
Gonca Gercel, Bekir Erdeve, Sinem Aydoner et al.
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In 30 seconds
This systematic review and meta-analysis evaluated surgical management outcomes for total colonic aganglionosis (TCA) in children, analyzing 134 patients across seven studies. No statistically significant differences were found between conventional pull-through (CPT) and non-conventional techniques (NCPT) or between Duhamel and ileoanal pull-through (IAPT) for outcomes such as fecal incontinence and mortality.
Key findings
- Pooled odds ratio for fecal incontinence was 1.1 for CPT vs NCPT (p = 0.837).
- No significant difference in mortality between Duhamel and IAPT (OR 1.03, p = 0.965).
- Requirement for additional interventions was higher in CPT vs NCPT with an OR of 4.3 (p = 0.074).
- No significant differences in postoperative intestinal obstruction between Duhamel and IAPT (OR 1.1, p = 0.875).
Why it matters
Understanding the outcomes of different surgical approaches for TCA is crucial for clinicians to make informed decisions tailored to individual patient needs, especially given the rarity of the condition and variability in surgical techniques.
What to keep in mind
The study highlights small sample sizes and clinical heterogeneity among included studies, which may affect the reliability of the findings.