{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:54:04Z","timestamp":1791179644181,"version":"4.1.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association between postoperative use of probiotics combined with glutamine and intestinal function recovery, Hirschsprung disease-associated enterocolitis (HAEC), nutritional status, and immune-inflammatory indicators following radical surgery for Hirschsprung disease (HD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective observational cohort study included children who underwent radical surgery for HD at our hospital between January 2023 and December 2025. According to the actual postoperative regimen received, patients were divided into an observation group receiving probiotics combined with glutamine in addition to conventional postoperative management (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200946) and a control group receiving conventional postoperative management alone without the probiotic preparation or glutamine supplementation used in the observation group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200948). A 1:1 propensity score matching (PSM) was performed to reduce confounding from measured baseline characteristics and improve covariate balance between the non-randomized treatment groups, resulting in 40 matched pairs. Postoperative recovery of bowel sounds, time to first defecation, length of hospital stay, HAEC incidence at 6 months postoperatively, and changes in nutritional markers (albumin, prealbumin, transferrin), peripheral blood T lymphocyte subsets (CD4\u207a, CD4\u207a\/CD8\u207a ratio), and inflammatory cytokines (IL-10, IL-6) were compared between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After PSM, the observation group exhibited significantly shorter times for recovery of bowel sounds, first defecation, and hospital stay compared to the control group [(22.5\u2009\u00b1\u20097.8) h vs. (34.6\u2009\u00b1\u20099.5) h, (38.5\u2009\u00b1\u200910.1) h vs. (51.8\u2009\u00b1\u200912.5) h, (10.5\u2009\u00b1\u20093.0) d vs. (14.4\u2009\u00b1\u20094.2) d, all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001]. At 6 months postoperatively, the incidence of HAEC was lower in the observation group than in the control group [10.0% (4\/40) vs. 32.5% (13\/40),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.014]. Baseline nutritional, inflammatory, and cellular immune indicators were comparable between the matched groups (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). From baseline to 3 months, the observation group showed greater increases in albumin, prealbumin, transferrin, IL-10, CD4 percentage, and CD4\/CD8 ratio and a greater decrease in IL-6 than the control group (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this retrospective observational cohort, postoperative use of probiotics combined with glutamine was associated with earlier intestinal function recovery, shorter hospitalization, a lower incidence of HAEC, and more favorable nutritional, cellular immune, and inflammatory indicators after PSM. These findings should be interpreted as associations rather than evidence of a causal treatment effect and require confirmation in prospective randomized studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1953553","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:32:13Z","timestamp":1791178333000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of probiotics combined with glutamine with postoperative outcomes in children with Hirschsprung disease: a retrospective propensity score-matched cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Peiyu","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery\/Pediatric Surgery, Renmin Hospital, Hubei University of Medicine","place":["Shiyan City, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingqing","family":"Wang","sequence":"additional","affiliation":[{"name":"Digestive Department, Cangzhou Central Hospital","place":["Cangzhou City, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Wei","sequence":"additional","affiliation":[{"name":"Digestive Department, Cangzhou Central Hospital","place":["Cangzhou City, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoqi","family":"Zheng","sequence":"additional","affiliation":[{"name":"Digestive Department, Cangzhou Central Hospital","place":["Cangzhou City, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Su","sequence":"additional","affiliation":[{"name":"Digestive Department, Cangzhou Central Hospital","place":["Cangzhou City, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1177\/1093526619892351","article-title":"Diagnosis of Hirschsprung disease","volume":"23","author":"Ambartsumyan","year":"2020","journal-title":"Pediatr Dev Pathol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"611","DOI":"10.3390\/medicina56110611","article-title":"Hirschsprung\u2019s disease-recent understanding of embryonic aspects, etiopathogenesis and future treatment avenues","volume":"56","author":"Klein","year":"2020","journal-title":"Medicina (B Aires)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e000878","DOI":"10.1136\/wjps-2024-000878","article-title":"Hirschsprung-associated enterocolitis: a comprehensive review","volume":"7","author":"Ziogas","year":"2024","journal-title":"World J Pediatr Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"4602","DOI":"10.3390\/ijms24054602","article-title":"Update on the pathogenesis of the Hirschsprung-associated enterocolitis","volume":"24","author":"Li","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2509","DOI":"10.1097\/JS9.0000000000000473","article-title":"Risk factors for Hirschsprung disease-associated enterocolitis: a systematic review and meta-analysis","volume":"109","author":"Zhang","year":"2023","journal-title":"Int J Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"S66","DOI":"10.1111\/apt.18068","article-title":"Hirschsprung\u2019s disease. Management","volume":"60","author":"Morera","year":"2024","journal-title":"Aliment Pharmacol Ther"},{"key":"B7","doi-asserted-by":"publisher","first-page":"101765","DOI":"10.1016\/j.bpg.2021.101765","article-title":"Hirschsprung disease and paediatric intestinal Pseudo-obstruction","author":"Chanpong","year":"2022","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e13732","DOI":"10.1111\/nmo.13732","article-title":"Hirschsprung disease: insights on genes, penetrance, and prenatal diagnosis","volume":"31","author":"Wang","year":"2019","journal-title":"Neurogastroenterol Motil"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1127375","DOI":"10.3389\/fimmu.2023.1127375","article-title":"Neuroimmune regulation in Hirschsprung\u2019s disease associated enterocolitis","volume":"14","author":"Ji","year":"2023","journal-title":"Front Immunol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"68","DOI":"10.5409\/wjcp.v12.i3.68","article-title":"Hirschsprung\u2019s disease associated enterocolitis: a comprehensive review","volume":"12","author":"Gershon","year":"2023","journal-title":"World J Clin Pediatr"},{"key":"B11","doi-asserted-by":"publisher","first-page":"151160","DOI":"10.1016\/j.sempedsurg.2022.151160","article-title":"Hirschsprung disease outcomes","volume":"31","author":"Short","year":"2022","journal-title":"Semin Pediatr Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1542\/pir.2020-004912","article-title":"Hirschsprung disease","volume":"42","author":"Mahon","year":"2021","journal-title":"Pediatr Rev"},{"key":"B13","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1053\/j.sempedsurg.2017.09.008","article-title":"Hirschsprung disease-bowel function beyond childhood","volume":"26","author":"Wester","year":"2017","journal-title":"Semin Pediatr Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"151165","DOI":"10.1016\/j.sempedsurg.2022.151165","article-title":"Total colonic aganglionosis in Hirschsprung disease","volume":"31","author":"Wood","year":"2022","journal-title":"Semin Pediatr Surg"},{"key":"B15","first-page":"477","article-title":"Hirschsprung disease associated enterocolitis: a systematic review and meta-analysis","volume":"79","author":"Poerwosusanta","year":"2024","journal-title":"Med J Malaysia"},{"key":"B16","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1007\/s00383-024-05667-3","article-title":"Children with Hirschsprung disease exhibited alterations in host-microbial co-metabolism after pull-through operation","volume":"40","author":"Thaiwatcharamas","year":"2024","journal-title":"Pediatr Surg Int"},{"key":"B17","first-page":"469","article-title":"Constipation in children and adolescents: evaluation and treatment","volume":"105","author":"Mulhem","year":"2022","journal-title":"Am Fam Physician"},{"key":"B18","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s00383-021-05020-y","article-title":"Prevalence of Hirschsprung-associated enterocolitis in patients with Hirschsprung disease","volume":"38","author":"Hagens","year":"2022","journal-title":"Pediatr Surg Int"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1458","DOI":"10.1016\/j.jpedsurg.2022.09.039","article-title":"Social determinants of health and Hirschsprung-associated enterocolitis","volume":"58","author":"Knaus","year":"2023","journal-title":"J Pediatr Surg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"2241","DOI":"10.3390\/microorganisms9112241","article-title":"Alterations of gut Bacteria in Hirschsprung disease and Hirschsprung-associated enterocolitis","author":"Chantakhow","year":"2021","journal-title":"Microorganisms"},{"key":"B21","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1038\/nrgastro.2017.149","article-title":"Hirschsprung disease\u2014integrating basic science and clinical medicine to improve outcomes","volume":"15","author":"Heuckeroth","year":"2018","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"151157","DOI":"10.1016\/j.sempedsurg.2022.151157","article-title":"The science of Hirschsprung disease: what we know and where we are headed","volume":"31","author":"Mueller","year":"2022","journal-title":"Semin Pediatr Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/1093526619893138","article-title":"Forward-Perspectives in pediatric pathology: Hirschsprung disease","volume":"23","author":"Rogers","year":"2020","journal-title":"Pediatr Dev Pathol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1016\/j.jpedsurg.2022.01.036","article-title":"Management of Hirschsprung associated enterocolitis-how different are practice strategies? An international pediatric endosurgery group (IPEG) survey","volume":"57","author":"Svetanoff","year":"2022","journal-title":"J Pediatr Surg"},{"key":"B25","doi-asserted-by":"publisher","first-page":"107722","DOI":"10.5409\/wjcp.v14.i4.107722","article-title":"Microbiota decolonization of bacterial pathogens in pediatric surgery-related intestinal disorders: insights on current strategies and future outlook","volume":"14","author":"Vaou","year":"2025","journal-title":"World J Clin Pediatr"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e20854","DOI":"10.7717\/peerj.20854","article-title":"The role of gut microbiota in Hirschsprung\u2019s disease: from pathogenic mechanisms to microbiota-targeted therapies","volume":"14","author":"Zhao","year":"2026","journal-title":"PeerJ"},{"key":"B27","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1007\/s12098-017-2371-8","article-title":"Hirschsprung disease\u2014current diagnosis and management","volume":"84","author":"Das","year":"2017","journal-title":"Indian J Pediatr"},{"key":"B28","doi-asserted-by":"publisher","first-page":"Cd013714","DOI":"10.1002\/14651858.CD013714.pub2","article-title":"Probiotics for the prevention of Hirschsprung-associated enterocolitis","volume":"4","author":"Mei","year":"2022","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1953553\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:32:14Z","timestamp":1791178334000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1953553\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":28,"alternative-id":["10.3389\/fped.2026.1953553"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1953553","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"article-number":"1953553"}}