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Published on: October 29, 2014
Long-term gastrointestinal sequelae in patients who underwent surgery for congenital duodenal obstruction
Adinda G H Pijpers1,2,3, Maaike Hogerwerf4,5,6,7, Fenne A I M Van den Bunder4,5,6
1Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam University Medical Centers, location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. a.pijpers1@amsterdamumc.nl.
Insights
Congenital duodenal obstruction surgery patients report similar long-term GI outcomes to healthy peers, though constipation is more frequent. Trisomy 21 did not significantly alter these outcomes.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Genetics
Background:
- Congenital duodenal obstruction (DO) necessitates early surgical intervention.
- Long-term gastrointestinal (GI) sequelae following DO surgery are not well-established.
- Understanding patient-reported outcome measurements (PROMs) is crucial for long-term care.
Purpose of the Study:
- To assess long-term GI PROMs in patients with DO using the Pediatric Quality of Life Inventory™ (PedsQL™) GI-Module.
- To compare PROMs between DO patients and a healthy control group.
- To evaluate differences in PROMs for DO patients with and without trisomy 21.
Main Methods:
- A cross-sectional cohort study was conducted from September to December 2023.
- The PedsQL™ GI-Module questionnaire was administered to patients who had DO surgery between 1999 and 2022.
- Data were compared to a published healthy control group (n=513) with Bonferroni correction.
Main Results:
- 33/89 DO patients completed the questionnaire; mean age was 13.3 years, 19/33 were female.
- Overall GI PROMs were similar between DO patients and healthy controls (p=0.075).
- Constipation scores were significantly lower in DO patients (p=0.002), indicating worse outcomes; other domains were similar. DO patients with and without trisomy 21 showed comparable PROMs.
Conclusions:
- Long-term GI PROMs after DO surgery are comparable to healthy individuals.
- Increased prevalence of constipation in DO patients warrants focused follow-up and education.
- Trisomy 21 status does not appear to significantly impact long-term GI PROMs in DO patients.
Background:
Congenital duodenal obstruction (DO) is an anomaly which requires surgery shortly after birth. However, its long-term gastrointestinal (GI) sequelae remain unknown. Therefore, this study aimed to determine the long-term GI patient-reported outcome measurements (PROMs) using the Pediatric Quality of Life Inventory™ (PedsQL™) GI-Module in patients with DO compared to healthy controls. Secondly, we evaluated the PROMs comparing patients with DO with and without trisomy 21.
Methods:
We performed a cross-sectional cohort study (September-December 2023). The PedsQL™ GI-Module questionnaire was sent to all patients who underwent DO surgery between 1999 and 2022. Data were compared with a published healthy control group (n = 513). Bonferroni correction was used to adjust for multiple tests.
Results:
In total, 33/89 patients completed the PedsQL™ GI-Module questionnaire. The majority of the patients were female (N = 19/33) with a mean age of 13.3 years (SD ± 6.6). Trisomy 21 was diagnosed in seven patients. The DO group had a similar mean total score compared to healthy controls (84.5 ± 11.5 vs. 88.6 ± 12.9,p = 0.075). The mean score for constipation (77.2 ± 22.0 vs. 86.9 ± 17.6,p = 0.002) was significantly lower compared to the healthy controls, indicating a worse outcome, whilst all other domains were similar. Four patients used laxatives. Patients with DO and trisomy 21 had similar scores compared to patients with DO without trisomy 21.
Conclusion:
The results showed similar long-term GI PROMs in patients who underwent DO surgery compared to healthy controls. Patients with DO experienced constipation more frequently, emphasizing the need for attention during follow-up and education of (parents) of patients. Additionally, children with DO and trisomy 21 showed similar PROMs to those without trisomy 21.
Level Of Evidence:
II.
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