{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T23:08:44Z","timestamp":1784243324886,"version":"3.55.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Hirschsprung disease (HD) is a rare malformation that requires complex corrective surgery. Low caseload, heterogeneous patient cohorts, and difficulties in linking long-term outcomes to the initial corrective surgery limit the available direct evidence for a volume-outcome relationship. Indirect evidence from adult colorectal cancer (CRC) surgery may be transferable, given the partial similarity of the procedures.<\/jats:p>\n                  <jats:p>Using the Institute for Quality and Efficiency in Health Care (IQWiG) V24\u201307 rapid report's methodology, this study evaluated the transferability of the volume\u2013outcome relationship from adult CRC surgery to corrective surgery for HD in children. Differences between the two populations were identified and rated for their effect on the transferability of the volume\u2013outcome relationship by an expert panel, following predefined IQWiG V24\u201307 categories.<\/jats:p>\n                  <jats:p>Consensus was reached for 6 out of 12 criteria. For \u201cdisease characteristics,\u201d \u201ccomorbidities,\u201d \u201cintervention,\u201d \u201cfollow-up,\u201d and \u201cconcomitant treatments,\u201d differences were deemed irrelevant to transferability. For \u201cdiagnosis,\u201d differences were considered to increase procedural complexity in HD, thereby reinforcing the volume\u2013outcome relationship. Tissue sampling and frozen-section pathology were identified as key challenges. Differences of opinion arose for the remaining criteria, particularly concerning whether the transferability of evidence is limited to rectal resections in adults or includes all colorectal resections. No consensus could be reached on the appropriate caseload threshold for corrective surgery for HD in children.<\/jats:p>\n                  <jats:p>Using the IQWiG V24\u201307 framework, this study provides strong support for the transferability of the volume\u2013outcome relationship from adult colorectal surgery to corrective surgery for HD. Despite population differences, the underlying mechanisms linking surgical complexity and institutional experience are comparable, reinforcing the relevance of volume-based quality control in pediatric surgery.<\/jats:p>","DOI":"10.1055\/a-2811-4806","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:45:19Z","timestamp":1771375519000},"page":"279-284","source":"Crossref","is-referenced-by-count":0,"title":["Indirect Evidence for the Volume\u2013Outcome Relationship in Corrective Surgery for Hirschsprung Disease: Insights from Adult Colorectal Surgery"],"prefix":"10.1055","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5288-6075","authenticated-orcid":false,"given":"Miriam","family":"Wilms","sequence":"additional","affiliation":[{"name":"Faculty of Health\/School of Medicine, Witten\/Herdecke University, Witten, NRW, Germany"},{"name":"Patient Organization for People with Anorectal Malformations and Hirschsprung Disease, SoMA E.V., Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9804-7084","authenticated-orcid":false,"given":"Max","family":"Samans","sequence":"additional","affiliation":[{"name":"Department of General-, Visceral-, Thorax and Pediatric Surgery, University Hospital of D\u00fcsseldorf, D\u00fcsseldorf, NRW, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Lacher","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University of Leipzig, Leipzig, Saxony, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Boemers","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Pediatric Urology, Children's Hospital of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7950-2104","authenticated-orcid":false,"given":"Eberhard","family":"Schmiedeke","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Urology, Centre for Child and Youth Health, Klinikum Bremen-Mitte, Bremen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Boettcher","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University Medical Centre Mannheim, Mannheim, Baden-W\u00fcrttemberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5415-8784","authenticated-orcid":false,"given":"Ekkehart","family":"Jenetzky","sequence":"additional","affiliation":[{"name":"Faculty of Health\/School of Medicine, Witten\/Herdecke University, Witten, NRW, Germany"},{"name":"Departement of Child and Adolescent Psychiatry, Johannes Gutenberg University Hospital Mainz, Mainz, Rheinland-Pfalz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali","family":"R\u00f6th","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery, RWTH Aachen University Hospital, Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich K.","family":"Fetzner","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Minimal-Invasive Oncological Surgery, Klinikum Altmuhlfranken, Gunzenhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Reck-Burneo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Surgery, Brandenburg an der Havel University Hospital, Brandenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"H\u00e4rtel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3206-6170","authenticated-orcid":false,"given":"Jochen","family":"Hubertus","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Marien Hospital Witten, Ruhr University Bochum, Witten, NRW, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Solari","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Surgery, Kepler University Hospital, Linz, Upper Austria, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1053\/j.sempedsurg.2019.04.013","article-title":"Error traps and culture of safety in Hirschsprung disease","volume":"28","author":"L De La 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