Long-term anorectal function after Duhamel operation for Hirschsprung's disease

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Colorectal Surgery

Background:

• Hirschsprung's disease is a congenital disorder affecting the large intestine.
• The Duhamel procedure is a surgical technique used to treat Hirschsprung's disease.
• Long-term anorectal function after surgery is a critical outcome measure.

Purpose of the Study:

• To assess long-term anorectal function in children treated with the Duhamel technique for Hirschsprung's disease.
• To identify factors influencing functional outcomes.
• To evaluate the effectiveness of a detailed questionnaire in assessing patient status.

Main Methods:

• Retrospective review of 75 patients operated on between 1977 and 1991.
• Analysis of detailed questionnaires completed by 63 patients over 2 years of age.
• Categorization of patients based on the extent of aganglionosis (rectosigmoid, long segment, total colon).

Main Results:

• No significant correlation found between age or sex and anorectal function.
• Long segment aganglionosis did not result in worse function than rectosigmoid aganglionosis.
• Only 1 of 7 patients with total colonic aganglionosis achieved continence; symptoms are often underreported due to patient adaptation.

Conclusions:

• The Duhamel technique's long-term functional outcomes vary, with total colonic disease posing significant challenges.
• Detailed questionnaires are reliable tools for assessing actual anorectal function in pediatric Hirschsprung's disease patients.
• Systematic follow-up is crucial for early detection and management of complications.