Pull-through procedures for Hirschsprung disease (HD) can be performed during the Neonatal Intensive Care Unit (NICU) stay or delayed until discharge following home irrigations. This study assesses the safety of a delayed pull-through as an alternative to neonatal reconstruction in infants with successful abdomen decompression with home irrigations based on Hirschsprung-associated enterocolitis (HAEC) development. A single-institution retrospective review of neonates with HD who underwent delayed or neonatal pull-through from July 2018–July 2022. Endpoints included post-pull-through HAEC incidence, recurrence at an 18-month follow-up, time to the first HAEC episode, NICU length of stay (LOS), and HAEC-related LOS. Twenty-four neonates were included. Eighteen were discharged from the NICU with home irrigations. Of these, 3 (28%) developed enterocolitis preoperatively, 12 (67%) underwent a delayed pull-through. NICU LOS in the delayed cohort was 3 times shorter than in the neonatal (6 vs. 18 days, p < 0.01). The incidence of enterocolitis (82% vs. 80%), time to the first episode (43 vs. 57 days), and HAEC-related LOS (median of 3 days) were similar. Delayed HD pull-through is a viable neonatal reconstruction alternative that reduces NICU stay without increasing the risk of postoperative HAEC development. Original Research Article. III.

中文翻译：

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新生儿重症监护病房拉通前家庭冲洗的评估：对先天性巨结肠疾病管理的影响

先天性巨结肠 (HD) 的拉通手术可以在新生儿重症监护病房 (NICU) 住院期间进行，也可以推迟到出院后家庭冲洗后进行。本研究根据先天性巨结肠相关小肠结肠炎 (HAEC) 的发展情况，评估了延迟拉出作为新生儿重建的替代方案的安全性，这些婴儿通过家庭冲洗成功进行腹部减压。对 2018 年 7 月至 2022 年 7 月期间接受延迟或新生儿拉断的 HD 新生儿进行的单机构回顾性评价。终点包括拉断后 HAEC 发生率、18 个月随访时复发、首次 HAEC 时间事件、NICU 住院时间 (LOS) 以及 HAEC 相关的 LOS。其中包括二十四名新生儿。十八人通过家庭冲洗从新生儿重症监护室出院。其中，3 例（28%）在术前出现小肠结肠炎，12 例（67%）经历了延迟拔除。延迟队列中的 NICU LOS 比新生儿短 3 倍（6 天与 18 天，p < 0.01）。小肠结肠炎的发生率（82% 与 80%）、首次发作时间（43 天与 57 天）以及 HAEC 相关的 LOS（中位时间为 3 天）相似。延迟 HD 转出是一种可行的新生儿重建替代方案，可减少 NICU 住院时间，同时不会增加术后发生 HAEC 的风险。原创研究文章。三．