Eur J Pediatr Surg 2021; 31(01): 040-048
DOI: 10.1055/s-0040-1715612
Original Article

Evaluation of Bowel Function, Urinary Tract Function, and Quality of Life after Transanal Endorectal Pull-Through Surgery for Hirschsprung's Disease

Cornelia Byström
1  Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden, Sweden
,
Sanna Östlund
1  Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden, Sweden
,
Nils Hoff
1  Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden, Sweden
,
Tomas Wester
1  Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden, Sweden
,
Anna Löf Granström
1  Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden, Sweden
› Author Affiliations

Abstract

Introduction The objective of this study is to determine short-term complications and evaluate long-term bowel function, lower urinary tract symptoms, and quality of life (QoL) in patients treated for Hirschsprung's disease (HSCR) with transanal endorectal pull-though (TERPT) compared with healthy controls.

Materials and Methods This cross-sectional case–control study included 30 HSCR patients treated with TERPT in 2006 to 2014 at Karolinska University Hospital, and 30 healthy controls matched for age and gender. Data on short-term complications were compiled from medical records and classified according to Clavien-Dindo. Bowel function and QoL were evaluated with the validated questionnaires bowel function score and KIDSCREEN-52. Lower urinary tract symptoms were evaluated through an 8-item lower urinary tract symptoms (LUTS) questionnaire.

Results Six (20%) patients had a short-term postoperative complication according to Clavien-Dindo, with insufficient pain management being the most common complication. The median age at follow-up was 7 years (range = 4–11). Median bowel function score was significantly lower in HSCR patients than in controls, 14 versus 19 (p < 0.001). Twenty-one of the HSCR patients reported impaired bowel function compared with two of the controls (p < 0.001). The overall prevalence of LUTS was 11 (38%) in the HSCR patients compared with seven (23%) in the controls (p = 0.751). HSCR patients reported a slightly lower QoL in the KIDSCREEN domain “financial resources” compared with controls (p = 0.008).

Conclusion According to Clavien-Dindo, short-term postoperative complications occurred in 20% of the patients. Impaired bowel function persists throughout childhood for most HSCR patients. The prevalence of LUTS and QoL is not affected in HSCR patients compared with controls.



Publication History

Received: 15 May 2020

Accepted: 14 July 2020

Publication Date:
02 September 2020 (online)

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