Clinical outcome and long-term quality of life after surgical correction of Hirschsprung's disease

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dc.contributor.authorMoore S.W.
dc.contributor.authorAlbertyn R.
dc.contributor.authorCywes S.
dc.date.accessioned2011-05-15T16:17:08Z
dc.date.available2011-05-15T16:17:08Z
dc.date.issued1996
dc.description.abstractOne hundred seventy-eight of 330 patients were recalled after undergoing surgery for histologically proven Hirschsprung's disease (HD). One hundred fifteen were older than 4 years at interview (Mean age, 10 years). This sample appeared to be representative of the whole in terms of demographic features such as ethnic group, sex, length of aganglionic segment, timing of presentation and surgery performed. Anthropomorphic indices for weight and height were comparable to norms, but many younger patients were below expected weight for age. In general, weight and height for age was regained with time. Nine patients had delayed developmental milestones, which were owing to specific causes in four. Nine patients had a poor functional outcome, of which two had neurological impairment. Satisfactory school performance was achieved in all but 19 (26%) of the remaining patients. Long- term functional results were comparable for the Scare and Duhamel procedures with less favorable results noted following the Swenson procedure. Assessment of complications demonstrated a significantly (P < .01) lower incidence of constipation, sexual dysfunction, and micturition disturbance following the Soave procedure when compared with the Duhamel and Swenson procedures. Neurological impairment and length of aganglionic segment beyond the rectosigmoid area appeared to influence functional outcome, as did persisting enterocolitis. Enterocolitis was observed in 16.6% of patients on presentation, but continued in only 6%. Constipation was particularly associated with the Duhamel procedure, and a higher incidence of micturition disturbance, abdominal distension, and cuff stricture was noted following the Swenson procedure. Functional assessment by three different scoring methods showed that 86 (74.7%) of the 115 patients over the age of 4 had excellent anorectal function and appeared to be well adjusted. Twenty-two patients (19.2%) had relatively minor long-term problems but seven (6.1%) had persistent fecal soiling with resulting psychosocial maladjustment.
dc.description.versionArticle
dc.identifier.citationJournal of Pediatric Surgery
dc.identifier.citation31
dc.identifier.citation11
dc.identifier.issn00223468
dc.identifier.other10.1016/S0022-3468(96)90164-5
dc.identifier.urihttp://hdl.handle.net/10019.1/14084
dc.subjectabdominal distension
dc.subjectadolescent
dc.subjectadult
dc.subjectanthropometric parameters
dc.subjectarticle
dc.subjectchild
dc.subjectconstipation
dc.subjectdemography
dc.subjectdevelopmental disorder
dc.subjectenterocolitis
dc.subjectfeces incontinence
dc.subjecthirschsprung disease
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmicturition disorder
dc.subjectneurologic disease
dc.subjectpriority journal
dc.subjectpsychosocial disorder
dc.subjectquality of life
dc.subjectsexual dysfunction
dc.subjectsurgical technique
dc.subjectAnal Canal
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectDefecation
dc.subjectEducational Status
dc.subjectFecal Incontinence
dc.subjectFollow-Up Studies
dc.subjectGrowth
dc.subjectHirschsprung Disease
dc.subjectHumans
dc.subjectIncidence
dc.subjectPostoperative Complications
dc.subjectQuality of Life
dc.subjectRectum
dc.subjectRetrospective Studies
dc.subjectSocial Adjustment
dc.subjectTreatment Outcome
dc.titleClinical outcome and long-term quality of life after surgical correction of Hirschsprung's disease
dc.typeArticle
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