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Long-term bowel functional outcomes after surgery for Hirschsprung disease: a comparative study of Duhamel and
Aika Namba1, Yunosuke Kawaguchi2, Tetsuya Mitsunaga1
1Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8677, Japan.
Purpose:
Long-term bowel dysfunction remains a major concern after surgery for Hirschsprung disease (HD). This study aimed to compare age-dependent bowel functional outcomes between the Duhamel procedure and transanal endorectal pull-through (TAEPT) up to 15 years.
Methods:
This retrospective single-center study included 101 patients who underwent surgery for HD between 1978 and 2025. Seventy-one patients underwent the Duhamel procedure, and 30 underwent TAEPT. Postoperative bowel function was assessed using a standardized bowel function score (BFS; maximum: 8), evaluating urge to defecate, constipation, incontinence, and soiling at 5, 7, 10, and 15 years.
Results:
Bowel function improved with age in both groups and plateaued by adolescence. The Duhamel group had significantly higher BFS than the TAEPT group at 5, 7, and 10 years (all P < 0.05). Domain-specific analysis exhibited improved urge to defecate at 5 and 7 years and better incontinence and soiling scores at 10 years in the Duhamel group. No significant differences were observed at 15 years.
Conclusion:
The Duhamel group had higher bowel function scores during childhood than the TAEPT group. However, these differences diminished with age, suggesting functional maturation. Understanding procedure-specific functional characteristics may contribute to individualized bowel management and improved long-term quality of life in HD.
