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Published on: April 26, 2019
Clinical outcome and bowel function after surgical treatment in Hirschsprung's disease
Maryam Khazdouz, Majid Sezavar, Bahareh Imani
1Department of Pediatric, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
Postoperative complications like constipation and incontinence are common after Hirschsprung disease surgery. Mortality rates in this study were higher than in developed nations, highlighting areas for improvement in patient care.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Outcomes Research
Background:
- Hirschsprung disease (HD) surgery can negatively impact bowel function.
- This study retrospectively analyzed clinical outcomes and bowel function post-surgery in HD patients.
Purpose of the Study:
- To evaluate short- and long-term gastrointestinal (GI) complications after pull-through operations for Hirschsprung disease.
- To identify the prevalence of associated anomalies and mortality rates in HD patients.
Main Methods:
- Retrospective analysis of 161 patients who underwent pull-through operations for HD between 2006-2011.
- Data extracted from Health Information System, analyzing Swenson, Duhamel, and Soave procedures.
- Investigated short- and long-term GI complications and associated anomalies.
Main Results:
- Mortality rate was 15.5% (25/161), with a higher incidence in males.
- Approximately 75% of patients experienced early and/or late GI complications.
- Most common complications included constipation (30.8%), incontinence (19.8%), enterocolitis (8%), and diarrhea (11%).
- Associated anomalies, including Down syndrome, were present in 28% of cases.
Conclusions:
- Constipation and fecal incontinence are the most frequent postoperative complications following HD surgery.
- Enterocolitis incidence was lower compared to other reported studies.
- Mortality rates were notably higher than those reported in developed countries.
Background:
Bowel function has been reported to be adversely affected following surgery in cases of Hirschsprung. We retrospectively studied both the clinical outcome and bowel function status following surgery in patients diagnosed with Hirschprung's disease (HD). 161 cases, who underwent pull-through operations for HD in Sheikh Pediatric Tertiary Centre, Mashhad, Iran. The specified time bracket spanned between 2006 and 2011.
Materials And Methods:
Data was extracted from Health Information System with the aim of investigating patients for both short and long-term gastrointestinal (GI) complications after surgery bases in addition to the concurrence of any associated anomalies. Three main procedures were analysed in this respect (Swenson, Duhamel and Soave).
Results:
In a study of 96 (59%) boys and 65 (40.3%) girls, mortality rate was reported to be 15.5% (15 males and 10 females). A considerable majority of almost three fourths were detected with both early and late GI complications after surgery. The latter mainly included constipation (30.8%), incontinence (19.8%), enterocolitis (8%), diarrhea (11%) in a declining order of incidence. Down syndrome and others HD-associated anomalies were detected in 3.7% and 24.3% of cases respectively.
Conclusions:
Constipation and foecal incontinence were the most prevalent postoperative complications, which were reported almost as frequent in other studies. Yet, Enterocolitis, was reported slightly less in prevalence. Also mortality rates were considerably higher, compared to developed nations.
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