Post-necrotizing enterocolitis (NEC) intestinal stricture is an important late complication among NEC survivors. Surgical management commonly involves primary anastomosis (PA) or staged enterostomy (SE), but comparative evidence in this population remains limited. We compared postoperative outcomes after PA and SE and developed a model to estimate the risk of prolonged postoperative length of stay (LOS). This single-center retrospective cohort study included 280 infants who underwent surgery for post-NEC intestinal stricture between January 2017 and December 2025. Outcomes after PA and SE were compared before and after 1:1 propensity score matching, with exact matching by sex and a caliper width of 0.2 standard deviations of the logit of the propensity score. Prolonged postoperative LOS was operationally defined as 19 days or longer, corresponding to the 75th percentile of the cohort rather than a validated universal clinical cutoff. Multivariable logistic regression was used to identify predictors of prolonged LOS and to develop a risk prediction model. Overall, 194 infants underwent PA and 86 underwent SE. After matching, 73 pairs were retained, and all absolute post-matching standardized mean differences were 0.17 or lower. In the matched cohort, PA was associated with a longer operative duration than SE (median, 96 vs. 90 min; P < 0.001), a similar time to enteral feeding (median, 7 vs. 7 days; P = 0.756), a shorter postoperative LOS (median, 15 vs. 18 days; P = 0.038). Individual major complications, including anastomotic leakage, were uncommon and did not differ significantly between groups, although the composite incidence of early postoperative complications was lower after PA (4.1

Apoptosis resistance, the severely immunosuppressive tumor microenvironment (TME), and the self-adaptive survival mechanisms of tumor cells significantly impair the efficacy of tumor therapies, driving us to seek more effective antitumor therapeutics that can induce devastative tumor death modalities. Herein, we present a biomineralized bacterial outer membrane vesicles-based nanocomposite (Gd-ZIF@OMV@DC661) designed to activate pyroptotic dualism while simultaneously blocking the pyroptotic checkpoint. Upon internalization by tumor cells, the nanocomposite undergoes acid-responsive degradation, releasing Zn2+, Gd3+, DC661 (a potent autophagy and lysosomal function inhibitor), and exposing OMVs with pyroptotic performance. Cellular oxidative stress induced by Zn2+ and Gd3+, in conjunction with lipopolysaccharide (LPS) presented by the outer membrane vesicles (OMVs), activates both caspase-1-dependent canonical and caspase-11-dependent non-canonical pyroptotic pathways. To counteract the tumor’s adaptive autophagic mechanisms—known as a pyroptotic checkpoint to suppress pyroptosis, the released DC661 inhibited tumor autophagy, deactivated pyroptotic actuators, amplified tumor pyroptosis, and simultaneously induced lysosomal cell death by causing lysosomal lipid peroxidation, thereby inducing robust immunogenic cell death. The consequent release of damage-associated molecular patterns (DAMPs) and tumor-associated antigens (TAAs) facilitates dendritic cell (DC) maturation and T-cell activation, driving a potent adaptive immune response. Furthermore, the presence of Gd³⁺ allows for real-time tumor tracking via T1-weighted magnetic resonance imaging. Overall, this study presents a multifunctional, theranostic nanoplatform that integrates dual pyroptosis, lysosomal cell death, and immune activation, offering a promising strategy for immune-silent solid tumor treatment.

Hirschsprung-associated enterocolitis (HAEC) in patients with Hirschsprung disease (HSCR) is a topic of concern. The aim of this study was to develop and validate a Nomogram model based on least absolute shrinkage and selection operator (LASSO) and Logistic regression for predicting postoperative HAEC in patients with HSCR. We retrospectively enrolled 424 HSCR patients who underwent one-stage Laparoscopic-assisted pull-through surgery. The cohort was randomly divided into a training cohort (n = 296) and validation cohort (n = 128) at a 7:3 ratio. LASSO regression identified significant predictors, followed by multivariable Logistic regression to develop the predictive model and generate a Nomogram. The model’s discrimination, accuracy, and clinical utility were assessed using receiver-operating characteristic (ROC) curves, Hosmer–Lemeshow test, and clinical decision curve analysis. The postoperative HAEC rate of 424 patients was 30.0

Background: The optimal timing of inguinal hernia repair in preterm and very young infants remains disputed. Early repair might prevent incarceration and ovarian or bowel compromise, whereas delayed repair might reduce postoperative respiratory morbidity during a period of respiratory maturation. Recent randomized evidence supports delayed repair in selected preterm infants, but source-reviewed real-world data from Asian pediatric surgical centers remain limited. Methods: A retrospective, source-reviewed target trial emulation was conducted using 6,424 consecutive pediatric inguinal hernia repair records from a tertiary pediatric surgical center in China. The primary cohort included infants aged 0–365 days at repair with plausible postmenstrual age (PMA) data, defined as 24–100 weeks (n=1,547). The exposure was repair at 55 weeks' PMA or earlier versus repair after 55 weeks' PMA. After automated case report form extraction, records were cross-validated by source-row linkage, and targeted source-note review was performed for all early-PMA respiratory events, all NICU/PICU transfers, and all early-PMA elective non-incarcerated candidates. The primary endpoint was a reviewed major postoperative adverse outcome, and the principal secondary endpoint was a reviewed postoperative respiratory event. Multivariable logistic regression with patient-clustered standard errors and propensity score overlap weighting were used. Findings: Among the 1,547 eligible infants, 796 underwent repair at 55 weeks' PMA or earlier and 751 underwent later repair. Source-note review reclassified 12 early-PMA respiratory event records as ICU-transfer-only events and identified 22 early-PMA elective-candidate records with acute-presentation text. The reviewed primary endpoint occurred in 130 of 796 (16.3%) infants in the early-PMA group and 45 of 751 (6.0%) in the later-PMA group. Reviewed postoperative respiratory events occurred in 114 of 796 (14.3%) versus 13 of 751 (1.7%). After overlap weighting, the estimated risk of the primary endpoint was 19.4% (95% CI 15.8–23.1) versus 8.1% (95% CI 5.6–10.9), with a risk difference of 11.3 percentage points (95% CI 6.2–15.4) and a risk ratio of 2.40 (95% CI 1.57–3.60). In adjusted logistic regression, early-PMA repair was associated with the primary endpoint (OR 3.19, 95% CI 2.05–4.98) and postoperative respiratory events (OR 9.75, 95% CI 4.77–19.94). Interpretation: Repair at 55 weeks' PMA or earlier identified infants at substantially higher risk of major postoperative adverse outcomes and postoperative respiratory morbidity. For clinically stable infants, elective repair after 55 weeks' PMA appears to be a safer default strategy when waiting is feasible, whereas infants requiring earlier repair should receive planned postoperative respiratory surveillance.

Objective Neonatal necrotizing enterocolitis(NEC)is a leading cause of death in neonates,especially in preterm infants.Sepsis is a common and severe complication after NEC onset.This study aims to evaluate the characteristics of sepsis development in NEC patients and to explore the association between sepsis and clinical outcomes of NEC.Methods This case-control study enrolled 178 neonates diagnosed with NEC admitted in our hospital from April 2022 to December 2023,who were matched 1∶1 with 178 non-NEC controls by birth weight,gestational age,and sex.All neonates were grouped according to the presence or absence of sepsis.Univariate analysis and stepwise-adjusted multivariate logistic regression were used to analyze risk factors for sepsis.The impact of sepsis on clinical outcomes in NEC patients was analyzed.Results The NEC group exhibited significantly older maternal gestational age(P<0.001)and a higher prevalence of congenital heart disease(P<0.02)compared with the control group.Among the 356 neonates,120 developed sepsis.Univariate analysis indicated that younger gestational age,lower birth weight,5-minute Apgar score≤7,and NEC were potentially associated with sepsis(all P<0.05).Univariate logistic regression analysis showed that NEC was a risk factor for sepsis(OR=2.042,95%CI:1.307 to 3.213,P=0.002).Stepwise-adjusted multivariate logistic regression analysis showed that after adjusting for gestational age,birth weight,and 5-min Apgar score,NEC remained a significant risk factor for sepsis(OR=2.141,95%CI:1.345 to 3.436,P=0.001).Among the NEC neonates,those with sepsis had a significantly higher surgical rate(52.70%vs 14.42%,P<0.001)and an increased mortality rate(22.97%vs 6.73%,P=0.002)than those without sepsis.Conclusion NEC significantly increases the risk of sepsis and leads to more adverse clinical outcomes.These findings suggest that NEC patients may require enhanced early identification and monitoring of sepsis to improve their clinical outcomes.

Early-onset sepsis (EOS) is a significant issue associated with high morbidity and mortality in newborns, yet it has not received adequate attention among neonatal necrotizing enterocolitis (NEC). This study aimed to investigate the clinical characteristics of NEC patients with EOS and to assess the association between EOS and NEC-related outcomes. : The retrospective case–control study included 196 NEC patients (Bell’s stage ≥ II) admitted to a tertiary neonatal intensive care unit from January 2023 to March 2025. Of these, 98 patients with EOS were matched to 98 controls (without EOS) based on birth weight, gestational age, and gender. The medical records of eligible patients were reviewed, and the clinical characteristics were systematically analyzed. Statistical analyses were performed using R software. The cohort included 196 patients, with a median gestational age of 32.1 weeks (IQR: 29.5, 34.4) and a median birth weight of 1615.0 g (IQR: 1227.5, 2050.0). Compared with the controls, cases showed significantly higher inflammatory markers (CRP and procalcitonin), lower platelet count, and higher incidences of hypoproteinemia, shock, and coagulopathy (all P < 0.05). Furthermore, ventilator support, blood transfusion, using of inotropes (dopamine), and Bell stage III were significantly more frequent among cases. Both the rate of surgical intervention [67.35

Purpose: This retrospective cohort study aimed to delineate the dynamic change trajectories of perioperative inflammatory markers in pediatric patients with Hirschsprung disease (HSCR) who underwent one-stage laparoscopic-assisted pull-through surgery at a single tertiary pediatric center using Group-Based Trajectory Modeling (GBTM), and to explore the association between different trajectory patterns and the risk of postoperative Hirschsprung-associated enterocolitis (HAEC). Methods: This study enrolled HSCR patients who underwent surgical treatment. Blood samples were collected at four perioperative time points (preoperative, postoperative days 1, 4, and 7) to calculate composite inflammatory markers such as the systemic inflammation response index (SIRI) and pan-immune inflammation value (PIV), as well as individual markers like white blood cell (WBC) and neutrophil counts. GBTM was employed to identify subgroups with similar inflammatory marker change trajectories. Multivariable logistic regression analysis was used to assess the association between different inflammatory trajectories and postoperative HAEC occurring within several years after surgery. Results: A total of 400 patients were included, of which 133 (33.3%) developed postoperative HAEC. Each inflammatory marker was categorized into 2-3 significantly distinct trajectory groups via GBTM. Multivariable logistic regression analysis revealed that for SIRI and PIV, compared to trajectory group 1 (low baseline with mild rise), patients in trajectory group 2 (moderate baseline with sharp rise and slow decline; SIRI: OR = 5.20, P = 0.011; PIV: OR = 4.75, P = 0.007) and trajectory group 3 (high baseline with sharp rise and slow decline; SIRI: OR = 4.73, P = 0.025; PIV: OR = 5.63, P = 0.008) had a significantly increased risk of postoperative HAEC. For WBC and neutrophils, trajectory group 2 (WBC: persistently high; neutrophils: low baseline with sharp rise and rapid decline) was an independent risk factor for postoperative HAEC (WBC: OR = 2.49, P = 0.004; neutrophils: OR = 2.53, P = 0.001). Conclusion: Specific rising trajectories of SIRI, PIV, WBC, and neutrophils may serve as novel biomarkers for early identification of children at high risk for HAEC.

Drug-eluting stents are effective for treating cardiovascular disease (CVD), but the procedure can cause mechanical damage to the endothelium, and the released antiproliferative agents delay reendothelialization and impair barrier function, ultimately leading to in-stent restenosis and disruption of vascular homeostasis. Current poststenting therapies, aimed at reducing proliferation and inflammation, often neglect endothelial cell (EC) repair and vascular homeostasis. To address this, we propose the use of a biomimetic nanozyme, HMPB-RAPA@PM LXW7 (HRPL). Hollow mesoporous Prussian blue (HMPB) nanoparticles serve as carriers for the antiproliferative drug rapamycin (RAPA), which is further modified with a peptide nanoarchitectonics platelet membrane (PM LXW7). This modification not only targets smooth muscle cells (SMCs) and ECs but also promotes EC repair to accelerate reendothelialization. In response to the acidic inflammatory microenvironment, HRPL releases RAPA to inhibit SMC proliferation and prevent restenosis. Additionally, the nanozyme scavenges reactive oxygen species (ROS), alleviates inflammation, and improves the vascular microenvironment. Both in vivo and in vitro experiments demonstrated that HRPL effectively accelerated reendothelialization, regulated SMC behavior, and reduced inflammation. In conclusion, this peptide nanoarchitectonics biomimetic nanozyme can promote endothelial repair, inhibit neointimal hyperplasia, modulate the inflammatory microenvironment, prevent restenosis, and restore vascular homeostasis, offering a promising approach to reduce complications following clinical stent implantation.

ObjectiveContrast enema (CE) is widely used for suspected post-NEC intestinal strictures, yet some surgically confirmed strictures show no direct stenosis on CE. We aimed to characterize clinical and CE findings in these cases and identify features associated with multi-segment involvement to inform preoperative management.MethodsWe retrospectively reviewed 191 infants with surgically confirmed post-NEC intestinal strictures who underwent preoperative CE. Infants were classified as CE-positive (direct stenosis on CE) or CE-negative (no direct stenosis). Based on intraoperative findings, strictures were further categorized as single-segment or multi-segment. Clinical characteristics and radiographic signs were compared between groups.ResultsOf 191 infants, 153 were CE-positive and 38 were CE-negative. CE-negative infants had a higher rate of prematurity (78.95% vs. 52.94%, P = 0.004) and lower birth weight (median 1960 g vs. 2,530 g, P = 0.001). CE-negative strictures more frequently involved the ileum and right colon, with a markedly higher rate of isolated small-bowel involvement (39.47% vs. 1.31%, P < 0.001). Indirect radiographic signs were common in CE-negative infants, including small-bowel dilatation (73.68% vs. 25.49%, P < 0.001) and microcolon (39.47% vs. 1.31%, P < 0.001). Bead-like/sausage-like appearance was independently associated with multi-segment involvement (OR = 24.90, P < 0.001).ConclusionIn surgically confirmed post-NEC strictures without direct stenosis on CE, infants are more often premature with lower birth weight, and lesions tend to involve the ileum and right colon. Indirect CE signs such as small-bowel dilatation and microcolon may support clinical decision-making in CE-negative cases, and bead-like/sausage-like appearance suggests a high likelihood of multi-segment involvement.

The association between Hirschsprung-associated enterocolitis (HAEC) and the inflammatory burden index (IBI) remains unclear. This study aimed to delineate the dynamic perioperative IBI trajectories in patients with Hirschsprung disease (HSCR) using group-based trajectory modeling (GBTM) and to explore the association between different trajectory patterns and postoperative HAEC risk. A total of 400 HSCR patients who underwent one-stage laparoscopic-assisted pull-through surgery at Children's Hospital of Chongqing Medical University were retrospectively enrolled. Complete blood count and C-reactive protein data collected at four perioperative time points (preoperative, postoperative days 1, 4, and 7) were used to calculate IBI. GBTM was applied to identify dynamic IBI trajectories. Multivariable logistic regression was performed to evaluate the independent association between distinct IBI trajectories and postoperative HAEC, with sensitivity analyses conducted using Bootstrap resampling and multiple assignment strategies. Three distinct perioperative IBI trajectories were identified: trajectory group 1 (mild postoperative rise followed by a slow decline, n = 75), trajectory group 2 (significant postoperative rise followed by a rapid decline, n = 246), and trajectory group 3 (significant postoperative rise followed by a slow decline, n = 79). The overall incidence of postoperative HAEC was 33.3

Sepsis after neonatal necrotizing enterocolitis (NEC) onset was associated with substantially adverse outcomes. However, effective tools for predicting sepsis risk in this special population remain lacking. This study aimed to investigate the influence of sepsis after NEC onset on the outcomes and develop a prediction model for early identification of sepsis. Retrospective review of 530 patients diagnosed with NEC was reviewed with clinical data. In this study, the overall proportion of sepsis was 56.2% (298/530). The rates of surgical intervention (63.09% vs. 18.10%) and mortality (17.11% vs. 3.88%) were higher in patients with sepsis than in those without (P < 0.05). The entire cohort was randomly assigned to a training set (n = 371) or testing set (n = 159) at a 7:3 ratio. LASSO-Logistic regression analysis showed that gestational age, age at NEC onset, C-reactive protein level, ventilator support, and hypoproteinemia were independently associated with sepsis (all P < 0.05), and a Nomogram model was developed based on these determinants. The area under the receiver operator characteristic curve of the training set was 0.937 (95% confidence interval [CI]: 0.813-0.960) and that of the testing set was 0.917 (95% CI: 0.876-0.957). The H-L goodness-of-fit test and calibration curve showed the forecast was in good agreement with the actual situation (both P > 0.05), whereas the decision curve analysis indicated the model's practical utility for clinical decision-making with a probability threshold of 0.03. This Nomogram model for predicting sepsis demonstrated desirable discriminative performance, aiding clinicians in enhancing risk assessment and facilitating early preventive interventions.

This study aimed to identify preoperative factors associated with stoma use in infants with post-NEC intestinal strictures and to develop a pragmatic model estimating the probability of staged stoma strategy selection. A retrospective cohort of 325 infants who underwent surgery for NEC-related strictures at a single center (2010–2024) was analyzed. Preoperative variables were evaluated using LASSO logistic regression and multivariable modeling. Four independent predictors associated with stoma use were identified: hematochezia, elevated CRP (> 8 mg/L), higher preoperative WBC, and lower weight at surgery. The model demonstrated good discrimination (AUC 0.814), with temporal validation AUC of 0.779. Preoperative inflammatory burden and lower weight at surgery were associated with stoma use in infants with post-NEC intestinal strictures. The model may support preoperative counseling and surgical planning, but should be interpreted as estimating the probability of stoma strategy selection in our institutional practice rather than defining objective indications for either stoma formation or primary anastomosis.

Anorectal malformation (ARM) is the most common congenital digestive tract anomaly in newborns, and children with ARM often have varying degrees of underdevelopment of the pelvic floor muscles (PFMs). To explore the effects of Rarα (NR1B1) and Pitx2 on the development of rat PFMs, we constructed a rat ARM animal model using all-trans retinoic acid (ATRA), and verified the expression of Rarα and Pitx2 in the PFMs of fetal rats. Additionally, we used rat myoblasts (L6 cells) to investigate the regulatory roles of Rarα and Pitx2 in skeletal muscle myoblast differentiation and their interactions. The results indicated a significant decrease in the expression of Rarα and Pitx2 in the PFMs of fetal rats with ARM. ATRA can also decrease the expression of Rarα and Pitx2 in the L6 cells, while affecting the differentiation and fusion of L6 cells. Knocking down Rarα in L6 cells reduced the expression of Pitx2, Myod1, Mymk, and decreased myogenic activity in L6 cells. When Rarα is activated, the decreased expression of Pitx2, Myod1, and Mymk and myogenic differentiation can be restored to different extents. At the same time, increasing or inhibiting the expression of Pitx2 can counteract the effects of knocking down Rarα and activating Rarα respectively. These results indicate that Pitx2 may be downstream of the transcription factor Rarα, mediating the effects of ATRA on the development of fetal rat PFMs.

This study summarizes the clinical characteristics of colostomy in children with anorectal malformation (ARM) with rectoperineal fistula (RPF) or rectovestibular fistula (RVF) to inform surgical decision-making. Medical records of children with RPF or RVF undergoing colostomy were retrospectively reviewed to analyze indications. Among 761 rectoperineal fistula and 295 rectovestibular fistula patients, 124 received colostomy: 16 (2.1

ABSTRACT High‐contrast imaging and effective treatment of hepatocellular carcinoma (HCC) remain challenging, largely due to the limited tumor selectivity of existing contrast agents and the absence of stable and broadly conserved therapeutic targets. Herein, we report a photoactivatable molecular magnetic resonance/fluorescence (MR/FL) imaging probe for sensitive HCC imaging and potent tumor eradication that exploits the intrinsically RNA‐enriched nature of HCC. Upon light irradiation, singlet oxygen ( 1 O 2 ) triggers in situ furan–RNA crosslinking, prolonging its rotational correlation time ( τ r ), thereby markedly amplifying r 1 relaxivity. Notably, this light‐activated furan–RNA crosslinking strategy affords a 75% enhancement in tumor MR signal, significantly outperforming clinically used MR contrast agents. FL imaging further reveals prolonged tumor retention with detectable signals persisting for over 14 days, highlighting its potential for longitudinal monitoring of therapeutic response. Concurrently, photo‐generated 1 O 2 and following RNA crosslinking results in multiple cell death mechanism, including pyroptosis, ferroptosis and RNA interference, enabling sustained tumor suppression. This work presents the first photoactivatable RNA‐targeted MR/FL imaging probe and establishes a new paradigm that integrates molecular‐level MRI signal amplification, long‐term tumor retention, and multi‐pathway synergistic antitumor therapy for holistic HCC management.

Nutritional problems in patients with anorectal malformation (ARM) after anorectoplasty have not received sufficient attention. This study aimed to establish prediction model of postoperative undernutrition for patients with complex ARM. Retrospective review of 104 patients with complex ARM was conducted with assessments of clinical data. Lasso-Logistic regression analysis was used to identify independent factors, and then establish a Nomogram model for predicting postoperative undernutrition. Harrell’s concordance index and calibration curves were applied to evaluate the performance of this model. R software was used for statistical analysis. Of the 104 patients, the proportion of malnutrition was 28.85

Meckel’s diverticulum (MD) is the most common congenital anomaly of the small intestine, and often leads to various complications in children. This study aims to compare the efficacy and safety of single-incision laparoscopic surgery (SILS) and conventional laparoscopic surgery (CLS) in the treatment of MD in children. Retrospective review of patients who underwent laparoscopic surgery for MD at a tertiary pediatric hospital from February 2017 to February 2023 was conducted with registered of demographic information, preoperative laboratory results, operative findings, and postoperative outcomes. Based on the surgical strategy, patients were classified into SILS and CLS groups. Propensity score matching (PSM) was employed to adjust for confounding factors, resulting in 188 matched pairs. Using PSM, the two groups were compared for baseline differences and postoperative outcomes. Of the 561 patients, the SILS-to-CLS ratio was 301: 260. After one-to-one PSM, results showed that compared with the CLS group, the SILS group had a significantly shorter postoperative hospital stay (P = 0.004), and earlier excretion time and fasting time (P < 0.05). Furthermore, SILS resulted in better scar assessment and higher satisfaction score (both P < 0.05). The two groups had no significant differences in the rates of postoperative complications (P = 0.439) and readmission (P = 0.291). Conversion to open surgery was more common in the SILS group (10.6

PURPOSE:Sex differences in Hirschsprung disease (HSCR) incidence have been well documented, yet little is known about whether the effect of sex on postoperative outcomes. This study aims to investigate the sex differences of postoperative outcomes of HSCR using propensity score matching (PSM) analysis. METHODS:Retrospective review of 304 patients with HSCR who received single-stage laparoscopic transanal pull-through modified Swenson procedure in a single-center was conducted with assessments of clinical data. By using PSM, baseline characteristics and postoperative outcomes between different sexes were compared. Furthermore, Univariate/multivariate Logistic regression analysis was used to identify sex as an independent factor of postoperative complications within 30 days and bowel dysfunction. RESULTS:Of the 304 patients, the proportion of females was 18.1 % (55/304). After one-to-one PSM, results showed that female patients had significantly longer length of postoperative hospital stay (12.60 ± 4.13 days vs. 10.62 ± 2.83 days, P = 0.005), lower health-related quality of life score (93.9 ± 4.2 vs. 97.3 ± 3.3, P < 0.001), higher rates of postoperative complications within 30 days (31 % vs. 13 %, P = 0.033) and bowel dysfunction (65.4 % vs. 36.5 %, P = 0.003) than males. However, statistically insignificant differences were observed among females and males in the surgical time, severity of complications, postoperative nutritional status, Hirschsprung-associated enterocolitis, and health-related quality of life (HRQoL) in physical and social domains (all P > 0.05). Furthermore, Multivariate Logistic regression analysis revealed that female was an independent risk factor for postoperative complications within 30 days (OR = 5.065, P = 0.024) and bowel dysfunction (OR = 3.153, P = 0.019). CONCLUSIONS:Following adjustment for HSCR patient characteristics, females may face more severe postoperative outcomes than males. In clinical practice, pediatric surgeons should pay more attention to these differences and develop individualized response measures, eg. optimizing the preoperative nutritional status and surgical procedure, formulating gender-specific strategies for defecation function management and perineal-anal care, and emphasizing the dynamic assessment of HRQoL. LEVEL OF EVIDENCE:Level 4.

This study aims to investigate the relationship between postoperative short-term complications and bowel function in patients with Hirschsprung disease (HSCR), and to explore the risk factors affecting bowel function. The medical records of 367 eligible patients diagnosed with HSCR were reviewed. According to the bowel function score (BFS), patients were divided into a normal bowel function group (200 cases, BFS > 17) and an abnormal bowel function group (167 cases, BFS ≤ 17), and the possible risk factors for poor bowel function were evaluated through univariate and multivariate analysis. According to the Clavien Madadi (CM) classification of complications, CM grades I and II were considered mild complications and CM III and IV were considered severe complications. According to binary logistic regression analysis, long-segment disease (OR = 3.255; 95