{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T10:22:08Z","timestamp":1787480528643,"version":"build-2736575974"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003The study aimed to compare 1-year outcomes for primary versus multiple-staged (three operations with colostomy) repairs in Hirschsprung's disease (HD).<\/jats:p><jats:p>\n          Materials and Methods\u2003Retrospective analysis of a large national administrative database (Hospital Episode Statistics) including all the neonates born with HD in England between 2003 and 2015. Main outcomes were: 1-year mortality, postoperative readmissions, and reoperations. Secondary outcomes: cumulative length of hospital stay (cLOS) and hospital volume\u2013outcome relationship.<\/jats:p><jats:p>\n          Results\u2003A total of 1,333 neonates with HD were treated in 21 specialist pediatric surgical centers; 874 (65.5%) patients had a primary repair for HD. One-year mortality was 2.8%. The overall readmission rate was 70.2%, with a significant difference between primary and multiple-staged repair (79.9 vs. 90.1%, p\u2009&lt;\u20090.01). There was no difference in reoperation. Primary pull-through was associated with a significantly lower probability of postoperative readmission (odds ratio [OR]\u2009=\u20090.08, 95% confidence interval [CI]\u2009=\u20090.06\u20130.11, p\u2009&lt;\u20090.001) and cLOS (OR\u2009=\u20090.38, 95% CI\u2009=\u20090.28\u20130.52, p\u2009&lt;\u20090.001) compared with multiple-staged repair. There were no significant difference in outcomes between patients treated in low-volume (&lt;37 cases\/year) and high-volume (&gt; 55 cases\/year) specialist centers.<\/jats:p><jats:p>\n          Conclusion\u2003Whenever clinically indicated, primary repair should be used in HD as this is associated with fewer readmissions and shorter time spent in the hospital.<\/jats:p>","DOI":"10.1055\/s-0039-3402712","type":"journal-article","created":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T18:54:57Z","timestamp":1578423297000},"page":"104-110","source":"Crossref","is-referenced-by-count":9,"title":["Outcomes of Primary versus Multiple-Staged Repair in Hirschsprung's Disease in England"],"prefix":"10.1055","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4555-3093","authenticated-orcid":false,"given":"Stefano","family":"Giuliani","sequence":"additional","affiliation":[{"name":"Division of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Honeyford","sequence":"additional","affiliation":[{"name":"Dr Foster Unit, Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chieh-Yu","family":"Chang","sequence":"additional","affiliation":[{"name":"Dr Foster Unit, Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Bottle","sequence":"additional","affiliation":[{"name":"Dr Foster Unit, Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Aylin","sequence":"additional","affiliation":[{"name":"Dr Foster Unit, Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,1,7]]},"container-title":["European Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-3402712.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T18:40:28Z","timestamp":1582051228000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-3402712"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,7]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2020,2,18]]},"published-print":{"date-parts":[[2020,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-3402712","relation":{},"ISSN":["0939-7248","1439-359X"],"issn-type":[{"value":"0939-7248","type":"print"},{"value":"1439-359X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,7]]}}}