Long-term anal sphincter performance after surgery for Hirschsprung's disease

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Physiology

Background:

• Hirschsprung's disease is a congenital condition affecting the large intestine.
• Surgical repair in childhood can lead to long-term functional issues in adulthood.
• Assessing anal sphincter function is crucial for understanding fecal continence outcomes.

Purpose of the Study:

• To evaluate anal sphincter performance in adult patients with a history of Hirschsprung's disease.
• To correlate manometric findings with clinical fecal continence status.
• To identify potential causes of dysfunction and factors contributing to satisfactory outcomes.

Main Methods:

• Anorectal manometry and clinical examinations were performed on 54 adult patients with repaired Hirschsprung's disease.
• Fecal continence was assessed using a quantitative scoring system (0-14).
• A control group of 30 healthy adults was included for comparison.

Main Results:

• Patients exhibited significantly lower median anal resting pressure compared to controls.
• No significant difference in maximal squeeze pressure was observed between patient subgroups.
• Voluntary sphincter force was comparable between patients and controls, despite lower resting pressures in patients.

Conclusions:

• A positive correlation exists between functional outcome and anal resting pressure in adults with repaired Hirschsprung's disease.
• Low resting pressure suggests internal sphincter dysfunction, potentially from surgical trauma.
• Satisfactory functional outcomes are likely due to normal voluntary sphincter control.