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Comparative review of functional outcomes post surgery for Hirschsprung's disease utilizing the paediatric

Olugbenga Michael Aworanti1, Dermot Thomas Mcdowell, Ian Michael Martin

  • 1Department of Paediatric Surgery, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland. drgbenga@hotmail.com

Pediatric Surgery International
|September 25, 2012
PubMed

Insights

The Paediatric incontinence/constipation scoring system (PICSS) shows similar functional outcomes for Soave and transanal pull-through surgeries in Hirschsprung

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Clinical Outcomes Research

Background:

  • Hirschsprung's disease (HD) requires surgical intervention to restore bowel function.
  • Assessing long-term functional outcomes after HD surgery is crucial for patient management.
  • Standardized scoring systems are needed to objectively evaluate continence and constipation post-operatively.

Purpose of the Study:

  • To compare functional outcomes in children undergoing Soave versus transanal endorectal pull-through for Hirschsprung's disease.
  • To utilize the Paediatric incontinence/constipation scoring system (PICSS) for outcome assessment.
  • To determine if PICSS identifies differences in continence and constipation rates between surgical approaches.

Main Methods:

  • Retrospective review of pediatric patients with HD operated between 1997-2010.
  • Exclusion of patients with total colonic aganglionosis and Down's syndrome.
  • Application of the PICSS to assess functional outcomes, defining incomplete continence or constipation based on age-specific confidence intervals.

Main Results:

  • PICSS analysis was completed for 51 patients (35 Soave, 16 transanal).
  • Incomplete continence rates were 75% (Soave) and 71% (transanal) (p=1.00).
  • Constipation rates were 34% (Soave) and 25% (transanal) (p=0.74), with no significant difference between groups.

Conclusions:

  • The PICSS is a sensitive tool for evaluating functional outcomes after Hirschsprung's disease surgery.
  • Both Soave and transanal endorectal pull-through procedures demonstrate comparable functional outcomes in terms of continence and constipation.
Abstract

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