IMMUNOLOGICAL PREDICTORS OF POSTOPERATIVE COMPLICATIONS IN CHILDREN WITH HIRSCHSPRUNG’S DISEASE

Аннотация

This study investigated immunological predictors of postoperative complications in children with Hirschsprung’s disease (HD). Forty-eight children undergoing radical surgery were examined; 20 developed postoperative enterocolitis as the main complication. Immune parameters—secretory IgA, serum IgG, IL-6, TNF-α, and neutrophil-to-lymphocyte ratio—were analyzed. Children with complications had significantly lower IgA (by 45 %), lower IgG (by 20 %), and higher IL-6 and TNF-α levels (2.1- and 1.8-fold increase, respectively; p<0.05). The neutrophil-to-lymphocyte ratio increased 1.6 times (p<0.05). These findings indicate that immune dysfunction may predict postoperative complications and help identify children at risk before surgery. Keywords Hirschsprung’s disease; postoperative complications; immunological predictors; children; cytokines; IgA. Relevance Postoperative complications, particularly enterocolitis, remain a serious challenge after surgical treatment of Hirschsprung’s disease. The incidence of such complications can reach up to 40 %, contributing to significant morbidity and mortality in this population. Despite surgical advancements, the ability to predict and prevent complications is limited. Recent evidence highlights the role of immune dysregulation—such as impaired mucosal immunity, decreased secretory IgA and serum IgG, and elevated proinflammatory cytokines—in the pathogenesis of these outcomes. Identifying immunological predictors of complications before surgery could allow risk stratification and targeted prevention. Therefore, studying immune parameters as potential predictors of postoperative complications is highly relevant for improving clinical outcomes in children with Hirschsprung’s disease. Objective To identify immunological predictors of postoperative complications in children with Hirschsprung’s disease by analyzing systemic and local immune parameters. 76 ACADEMIC RESEARCH IN MODERN SCIENCE International scientific-online conference