PERIOPERATIVE TOTAL PARENTERAL NUTRITION IN DUHAMEL’S PROCEDURE FOR NEONATAL HIRSCHSPRUNG’S DISEASE

Ma JD, Zhang XL, Ye ZZ, Ma RB

Department of Surgery,

Capital Institute of Pediatrics, Beijing 100020, China

 

Objective: To evaluate use of total parenteral nutrition (TPN) in Duhamel’s procedure for Hirschsprung’s disease (HD) in neonates.

Methods: Treatment in five neonates with long segment or common type of HD was studied. TPN was used perioperatively and administrated peripheral introvenously. The data showed in the table.

Table Report of five cases

CaseNo.

type of HD

Wave of relax

Age

(day)

BW*

(kg)

TPN  period

 

Calory

(kcal/d.kg)

Nitrogeng

(g/d.kg)

C:N ratio

1

 long 

(--)

15

3.52

-8~+8

80

0.42

190:1

2

 long 

(--)

17

4.20

-7~+8

68

0.34

200:1

3

 long 

(--)

30

2.50

-8~+10

84

0.40

210:1

4

 long 

(--)

14

3.43

-6~+10

77

0.45

171:1

5

 long 

(--)

15

4.00

-6~+8

77

0.36

214:1

*: The body weight at operation. : Perioperative  day.  #: Operation age.

Results: The use of TPN exempt from the colonic lavage. All the patients kept their body weight. They underwent primary Duhamel’s procedure without colostomy and had an uneventful postoperative days. The fecal control were continence completely.

Conclusions: Operation in the newborns with HD could not only shorten the hospital stay and decrease the cost but also save the colon before its dilatation. Perioperative TPN provided the possibility to perform radical procedure one stage in neonates avoiding colonic lavage. The authors suggested this method could be used in thoses hospital where TPN was clinically used under the supervison of experienced surgeons. 

 
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