| Hirschsprung's disease in Japan: analysis of 3852 patients based on a nationwide survey in 30 years. | |
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MedLine Citation:
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PMID: 15868585 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND/PURPOSE: The introduction of laparoscope and transanal endorectal pull-through has caused a revolution in the operative procedures for Hirschsprung's disease. To study the changing profile of Hirschsprung's disease in Japan, the authors carried out a national survey. METHOD: Patient data were collected in 3 phases: group 1, 1628 patients between 1978 and 1982; group 2, 1121 patients between 1988 and 1992; and group 3, 1103 patients between 1998 and 2002, respectively. RESULTS: The incidence was 1:4697, 1:5544, and 1:5343 and the male/female ratio was 3.0:1, 3.4:1, and 3.0:1 in each group, respectively. Patients weighing less than 2500 g at birth increased to 10.4% in group 3, whereas they were 6.5% in group 2 and 5.5% in group 1. The patients with a family history also increased to 6.0% in group 3, in comparison with 2.8% in group 2 and 3.0% in group 1. The incidence of associated anomalies increased over time, 11.1% in group 1, 16.3% in group 2, and 21.2% in group 3. Mutations of genes were found in 4 of the 23 patients examined. The extent of aganglionosis was almost the same in each group. Regarding the definitive operation, the procedures without laparotomy, including transanal endorectal pull-through, increased up to 42.6% in group 3 but 0% in groups 1 and 2. The frequency that a primary operation without stoma was performed also increased. The age at definitive operation decreased in group 3. The incidence of preoperative and postoperative enterocolitis also decreased over time. The mortality was decreased over time, 7.1%, 4.9%, and 3.0% for groups 1, 2, and 3, respectively. CONCLUSIONS: The authors analyzed 3852 Japanese patients over 3 decades. The ratio of patients with a low birth weight, associated anomalies, or a family history was increased in the last 10 years. A primary operation without laparotomy has thus become the procedure of choice for a definitive operation. |
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Authors:
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Sachiyo Suita; Tomoaki Taguchi; Satoshi Ieiri; Takanori Nakatsuji |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of pediatric surgery Volume: 40 ISSN: 1531-5037 ISO Abbreviation: J. Pediatr. Surg. Publication Date: 2005 Jan |
Date Detail:
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Created Date: 2005-05-03 Completed Date: 2006-06-09 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0052631 Medline TA: J Pediatr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 197-201; discussion 201-2 Citation Subset: IM |
Affiliation:
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Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan. suita@pedsurg.med.kyushu-u.ac.jp |
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| MeSH Terms | |
Descriptor/Qualifier:
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Anal Canal
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abnormalities Anastomosis, Surgical Congenital Abnormalities / epidemiology Digestive System Surgical Procedures* Female Genetic Predisposition to Disease Health Surveys Hirschsprung Disease / diagnosis, epidemiology*, surgery* Humans Incidence Infant Infant, Low Birth Weight Infant, Newborn Japan / epidemiology Male Rectum / abnormalities Surgical Procedures, Minimally Invasive |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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