ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
76
IMMUNOLOGICAL PREDICTORS OF POSTOPERATIVE
COMPLICATIONS IN CHILDREN WITH HIRSCHSPRUNG’S DISEASE
Abdurakhmanova Isroiljon Ibrokhimjon
Doctor of the Emergency Medical Care Department
of the Kosonsoy District Medical Association.
https://doi.org/10.5281/zenodo.15847496
Abstract
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.
ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
77
Materials and Methods
Forty-eight children aged 1–36 months who underwent surgery for
Hirschsprung’s disease were enrolled. They were divided into two groups: those
with postoperative complications (n = 20) and those without (n = 28). Immune
parameters—including secretory IgA in stool, serum IgG, IL-6, TNF-α, and the
neutrophil-to-lymphocyte ratio—were assessed using ELISA and standard
hematological techniques. Statistical analysis was performed with the Student’s
t
-test and χ² test to determine significant differences between groups and
evaluate predictive potential.
Results
Children with postoperative complications had a 45 % decrease in
secretory IgA (
p
<0.01), a 20 % decrease in serum IgG (
p
<0.05), and significantly
elevated IL-6 and TNF-α levels—2.1 and 1.8 times higher than in children
without complications (
p
<0.01). The neutrophil-to-lymphocyte ratio was 1.6
times higher in the complication group (
p
<0.05). These statistically significant
differences suggest that immune abnormalities may serve as reliable predictors
of postoperative complications, allowing for early identification of high-risk
patients.
Conclusion
Immunological predictors—decreased IgA and IgG, elevated IL-6 and
TNF-α, and a shift toward neutrophilia—were associated with a higher risk of
postoperative complications in children with Hirschsprung’s disease. Assessing
these immune parameters preoperatively can help stratify risk and guide
preventive strategies. These findings emphasize the importance of immune
evaluation as part of preoperative assessment to reduce complication rates and
improve surgical outcomes in this vulnerable pediatric population.
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ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
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