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[Functional outcomes in postsurgery for Hirschsprung´s disease].

P Bragagnini Rodríguez1, Y González Ruiz2, A Siles Hinojosa2

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Summary

This study on Hirschsprung

Keywords:
ConstipationHirschsprung diseaseIncontinence

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Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Clinical Outcomes Research

Background:

  • Hirschsprung's disease (HD) is a congenital condition affecting the large intestine.
  • Surgical intervention is the primary treatment for HD.
  • Functional outcomes following surgery are critical for long-term patient well-being.

Purpose of the Study:

  • To analyze and compare the functional outcomes of patients who underwent surgery for Hirschsprung's disease.
  • To evaluate the influence of surgical technique (transanal endorectal pull-through vs. transabdominal approach) on outcomes.
  • To assess the impact of age at diagnosis and treatment on functional results.

Main Methods:

  • Retrospective analysis of 37 patients operated for Hirschsprung's disease between 2000 and 2014.
  • Data collected included surgical technique, age at diagnosis and operation, complications, and functional outcomes.
  • Functional outcomes, including incontinence/soiling and constipation, were evaluated at an average follow-up age of 9.6 years.

Main Results:

  • Incontinence/soiling occurred in 21.4% of patients, with a significantly higher rate in the transanal endorectal pull-through (TERPT) group (41.7%) compared to the transabdominal approach (TAB) group (6.2%).
  • Patients experiencing incontinence/soiling had a younger average age at follow-up (5.9 years) compared to those without (10.6 years).
  • Constipation occurred in 17.9% of patients, exclusively in the TAB group, particularly in those operated under one year of age.

Conclusions:

  • While TERPT showed a higher initial rate of incontinence/soiling, this improved with age, suggesting a shorter follow-up period for this group.
  • The transabdominal approach (TAB) was associated with a higher incidence of persistent constipation.
  • Surgical technique and age at operation significantly influence long-term functional outcomes in Hirschsprung's disease patients.