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Maternal separation (MS) is a well-studied phenomenon thought to play a role in the pathogenesis of many diseases ranging from neuropsychiatric to early intestinal disorders such as necrotizing enterocolitis. The existing evidence suggests that MS initiates a variety of processes that in turn lead to early intestinal injury. Although there are many theories as to how MS alters normal physiological processes, the exact mechanism of action remains to be elucidated. This review aims to describe some of the pathological processes affecting the intestine that are caused by MS, including (i) brain-gut axis, (ii) intestinal epithelial barrier function, (iii) microbiome, (iv) oxidative stress and endoplasmic reticulum stress, and (v) gut inflammation. Key words: maternal separation, neonatal intestinal injury, pathogenesis, necrotizing enterocolitis. La separation d'avec la mere (SM) est un phenomene bien etudie que l'on croit jouer un role dans la pathogenese de nombreuses maladies du domaine de la neuropsychiatrie aux maladies intestinales precoces comme l'enterocolite necrosante. Les donnees actuelles laissent entendre que la SM donnerait lieu a divers processus qui pourraient par la suite mener a des lesions intestinales precoces. Bien qu'il existe de nombreuses theories quant a la maniere dont la SM nuit a des processus physiologiques normaux, le mode d'action precis demeure a elucider. Cet article de synthese vise a decrire certains processus pathologiques touchant l'intestin et issus de la SM, notamment les suivants : (i) axe intestin-cerveau, (ii) barriere epitheliale intestinale fonctionnelle, (iii) microbiome, (iv) stress oxydatif et stress du reticulum endoplasmique et (v) inflammation intestinale. [Traduit par la Redaction] Mots-cles : separation d'avec la mere, lesions intestinales neonatales, pathogenese, enterocolite necrosante., Introduction Mother-offspring interactions are thought to be part of a complex array of events that shape neonates' early life development. The stress due to deprivation of physical contact can affect [...]

Aim:  The Duhamel pull-through and transanal endorectal pull-through (TEPT) are commonly used for the treatment of Hirschsprung's disease (HD). To date, there has been no meta-analysis evaluating postoperative outcomes following Duhamel pull-through and TEPT. The purpose of this meta-analysis was to compare patient outcome after Duhamel pull-through and TEPT for HD.Materials and Methods:  Original articles published between 1998 and 2016 were identified using the MEDLINE database. Studies comparing Duhamel pull-through and TEPT were included. Outcomes evaluated included incidence of postoperative constipation, incontinence/soiling, enterocolitis, anastomotic stricture, and leak. We analyzed dichotomous variables by estimating odds ratios (OR) with 95% confidence intervals (CI) and continuous variables using the weighted mean difference with 95% CI. The meta-analysis was done using RevMan 5.3.Result:  There were no randomized controlled trials. Seven observational clinical studies were included, comprising 260 cases of Duhamel pull-through and 170 cases of TEPT. Anastomotic stricture (OR = 0.10; 95%CI 0.02-0.48; p = 0.004) was lower following Duhamel pull-through than TEPT. There were no significant differences in the incidence of postoperative incontinence/soiling and anastomotic leak. After TEPT, postoperative constipation seems to be lower and enterocolitis higher compared with those after Duhamel pull-through; however, these differences are not significant when the follow-up period is equal between groups.Conclusion:  The Duhamel pull-through seems to be associated with lower incidence of anastomotic stricture compared with TEPT. The effects of the two analyzed operative techniques on constipation and enterocolitis remain unclear. The quality of evidence supporting the above findings is suboptimal, indicating the need for prospective studies. [ABSTRACT FROM AUTHOR]