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Long-term growth outcomes in children with Hirschsprung disease after definitive surgery: A cross-sectional study
Gita Christy Gabriela1, Esensi Tarian Geometri1, Griselda Elisse Santoso1
1Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
Insights
Long-term growth in children with Hirschsprung disease (HSCR) shows similar nutritional outcomes across Soave, Duhamel, and transanal endorectal pull-through (TEPT) surgical techniques. While some patients improve post-Soave and TEPT, overall nutritional status does not significantly differ between surgical methods.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Child Growth and Development
Background:
- Hirschsprung disease (HSCR) significantly impacts child growth.
- Environmental factors, nutrition, and surgical interventions are key influences on HSCR patient outcomes.
Purpose of the Study:
- To compare long-term growth outcomes (≥3 years follow-up) in children with HSCR.
- To evaluate nutritional status changes after different pull-through surgical procedures.
Main Methods:
- Cross-sectional study of pediatric patients (<18 years) with histopathologically confirmed HSCR.
- Inclusion criteria: pull-through surgery between 2012-2015.
- Prospective data collection on postoperative anthropometric and nutritional status via interviews/phone calls.
Main Results:
- 21 patients analyzed: Soave (n=7), Duhamel (n=4), TEPT (n=10).
- No significant preoperative or postoperative nutritional status differences between the three surgical groups (p=0.52).
- Nutritional status changes varied: Soave (28.6% improved), Duhamel (25% worsened), TEPT (40% improved), but differences were not statistically significant (p=0.42).
Conclusions:
- Nutritional status after HSCR pull-through surgery is comparable across Soave, Duhamel, and TEPT procedures.
- Some HSCR children experience nutritional improvement post-Soave and TEPT.
- Further multicenter studies with larger cohorts are needed to validate these findings.
Background:
The growth of children with Hirschsprung disease (HSCR) can be affected by many factors, including the environment, nutrient intake, and surgery. Our study compared the long-term (i.e., at least 3 years of follow-up) growth outcomes in HSCR children after transabdominal Soave and Duhamel and transanal endorectal pull-through (TEPT) surgeries.
Methods:
A cross-sectional study was conducted in children <18 years of age diagnosed histopathologically with HSCR who underwent pull-through between January 1, 2012-December 31, 2015 in our institution. The postoperative anthropometric data were obtained prospectively through interviews during the outpatient clinic appointment or by telephone.
Results:
We recruited 21 patients (Soave: 7 vs. Duhamel: 4 vs. TEPT: 10; p = 0.06). There were no significant differences between the three surgical methods in terms of preoperative and postoperative nutritional status categories (p = 0.52). Concerning the changes in nutritional status, after Soave surgery, it was improved, steady, and worsened in 28.6%, 57.1%, and 14.3% of the children, respectively. The nutritional status of the Duhamel group was worsened and steady in 25% and 75% of the children, respectively, while in the TEPT group, it was improved and steady in 40% and 60% of the children, respectively. However, these differences were not statistically significant (p = 0.42).
Conclusions:
While some HSCR children show an improvement in their nutritional status after Soave and TEPT procedures, the overall nutritional status is similar among different procedures. Further multicenter studies with a larger sample size are important to clarify our findings.
