Preoperative evaluation of the dysganglionic bowel segment is critical for establishing the optimal resection strategy for Hirschsprung’s disease (HSCR), which facilitates patient outcomes.

We set out to determine the utility of the 24-h delayed film of barium retention in predicting the length of dysganglionic bowel segment in HSCR.

A retrospective study of patients with clinically suspicious HSCR who underwent a preoperative 24-h delayed film of barium enema and were surgically treated from January 2015 to December 2019 was conducted.

Two hundred and 58 patients were enrolled in this study. The sensitivity, specificity, positive and negative predictive values (NPVs) of the 24-h delayed film of barium enema to predict the neuropathological segment were 89.1, 91.5, 91.3, and 89.4%, respectively. The Youden index was 80.6%, with a kappa value of 0.806 (P < 0.001). The correlation rate between barium retention level and pathological results was 72.7% (16/22) when aganglionosis was restricted within the mid-distal rectum (short-segment type), increasing to 92.0% (46/50) and 93.5% (174/186) for patients that had aganglionosis extended beyond the mid-distal rectum (classical type) and sigmoid colon (long-segment type), respectively. Lastly, patients younger than 3 months showed a lower correlation rate (72.2%) compared to patients aged 3–12 months (91.0%) and > 12 months (92.6%).

Our investigation of the 24-h delayed film of barium enema performed for patients suspected of having HSCR indicated that the barium retention level remains crucial in predicting dysganglionic bowel segment, which contributes to the decision-making for surgical physicians.

神经节异常肠段的术前评估对于建立先天性巨结肠 (HSCR) 的最佳切除策略至关重要，这有助于患者的预后。

我们着手确定 24 小时钡潴留延迟膜在预测 HSCR 中节段异常肠段长度方面的效用。

对 2015 年 1 月至 2019 年 12 月接受术前 24 小时延迟钡剂灌肠并接受手术治疗的临床可疑 HSCR 患者进行了一项回顾性研究。

2058 名患者参加了这项研究。钡灌肠24小时延迟片预测神经病理节段的敏感性、特异性、阳性和阴性预测值（NPVs）分别为89.1%、91.5%、91.3%和89.4%。Youden 指数为 80.6%，kappa 值为 0.806（磷< 0.001)。当神经节增生局限于直肠中段（短段型）时，钡潴留水平与病理结果的相关率为72.7%（16/22），增加到92.0%（46/50）和93.5%（174/ 186) 分别针对中段直肠（经典型）和乙状结肠（长段型）的神经节增生患者。最后，与 3-12 个月 (91.0%) 和 > 12 个月 (92.6%) 的患者相比，3 个月以下的患者显示出较低的相关率 (72.2%)。

我们对疑似患有 HSCR 的患者进行的 24 小时钡灌肠延迟片的调查表明，钡潴留水平对于预测神经节障碍性肠段仍然至关重要，这有助于外科医师的决策。