ORIGINAL RESEARCH article
Front. Surg.
Sec. Colorectal and Proctological Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1554493
Impact of preoperative bowel preparation methods on anastomotic leakage and intestinal motility recovery in laparoscope-assisted heart-shaped anastomosis (LHSA)
Provisionally accepted
- Anhui Provincial Children’s Hospital, Hefei, China
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Background: Hirschsprung's disease (HSCR) is a congenital bowel-obstructive disorder caused by the absence of enteric ganglion cells. While laparoscope-assisted heart-shaped anastomosis (LHSA) shows promise in surgical management, risks like anastomotic leakage persist. Preoperative bowel preparation is key in optimizing surgery outcomes. This study evaluates the efficacy of mechanical bowel preparation (MBP) versus MBP combined with oral antibiotics (OA) in reducing postoperative complications and improving recovery. Methods: This retrospective cohort study involved 215 HSCR patients who underwent LHSA between June 2020 and June 2023. Patients were divided into two groups: MBP+OA and MBP alone. Outcomes measured included anastomotic leakage, surgical site infections (SSIs), postoperative intestinal motility, inflammatory markers, postoperative recovery markers, and quality of life assessments.The OA+MBP group demonstrated a significant reduction in SSIs (2.65% vs. 9.80%, P = 0.028) and shorter postoperative LOS (4.20 ± 1.20 days vs. 4.80 ± 1.58 days, P = 0.002). Time to first stool (2.16 ± 0.71 days vs. 2.25 ± 0.72 days, P = 0.004) and full feeds (4.18 ± 1.34 days vs. 4.58 ± 1.36 days, P = 0.029) were improved in the OA+MBP group. On the fifth postoperative day, CRP levels were lower in the OA+MBP group (60.1 ± 19.7 mg/L vs. 67.4 ± 22.5 mg/L, P = 0.012).The addition of oral antibiotics to mechanical bowel preparation significantly decreases the risk of SSIs, enhances recovery, and improves both inflammatory profiles and bowel function in LHSA.
Keywords: Hirschsprung's disease, laparoscope-assisted heart-shaped anastomosis, Mechanical bowel preparation, Oral antibiotics, Surgical site infection, postoperative recovery
Received: 02 Jan 2025; Accepted: 15 Jul 2025.
Copyright: © 2025 Zhang, Wei, Bian and Qi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shijin Qi, Anhui Provincial Children’s Hospital, Hefei, China
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