[Late complications of Hirschsprung's disease and anorectal manometry]

In 84 patients treated with Soave-Denda method, informations of their bowel habits were obtained through a questionnaire. These patients were classified into 4 groups (A; less than 3 years, B; 3 to 6 years, C; 7 to 9 years and D; more than 10 years after the operation) and analyzed by comparing their bowel habits with those of normal children in corresponding age group. Some late complications were demonstrated although 80% of patients followed for more than 10 years had a normal bowel habit. Frequent incontinence (more than once a week) was found in 18.2% of group B and 5% of group C. No patients has incontinence in group D. Frequent soiling (more than once a week) was demonstrated in 58.8% of group B, 30% of group C and 23.1% of group D although the incidence of frequent soiling ranged from 0.5 to 2.1% in normal children of these age group. Manometry to detect a rectonal reflex was useful to evaluate anorectal function because patients who showed normal reflex had excellent bowel habits without incontinence. These unexpected high incidence of late complications indicate that postoperative training of defecation is extremely important to give normal bowel habit to the patients with Hirschsprung's disease.