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Long-term functional outcomes of patients with Hirschsprung disease following pull-through

BACKGROUND: Hirschsprung disease (HSCR) is a common congenital disorder presenting with functional obstruction due to aganglionosis of the colon. There are numerous types of pull-through surgery for managing HSCR, such as transabdominal endorectal (Soave), Swenson, Duhamel, transanal endorectal pull...

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Autores principales: Gunadi, Monica Carissa, Theodora, Stevie, Daulay, Ezzah Fatmala, Yulianda, Dicky, Iskandar, Kristy, Dwihantoro, Andi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9063042/
https://www.ncbi.nlm.nih.gov/pubmed/35505310
http://dx.doi.org/10.1186/s12887-022-03301-6
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author Gunadi
Monica Carissa, Theodora
Stevie
Daulay, Ezzah Fatmala
Yulianda, Dicky
Iskandar, Kristy
Dwihantoro, Andi
author_facet Gunadi
Monica Carissa, Theodora
Stevie
Daulay, Ezzah Fatmala
Yulianda, Dicky
Iskandar, Kristy
Dwihantoro, Andi
author_sort Gunadi
collection PubMed
description BACKGROUND: Hirschsprung disease (HSCR) is a common congenital disorder presenting with functional obstruction due to aganglionosis of the colon. There are numerous types of pull-through surgery for managing HSCR, such as transabdominal endorectal (Soave), Swenson, Duhamel, transanal endorectal pull-through (TEPT), and laparoscopic (Georgeson) approach. Here, we aimed to describe the long-term outcome of patients with HSCR who underwent transabdominal Soave, Duhamel, and TEPT in our institution. METHODS: We performed a cross-sectional analysis for patients who underwent Duhamel, Soave, and TEPT at our institution from January 2012 to December 2015. Long-term functional outcome was determined by bowel function score (BFS). The BFS was obtained by interviewing patients who had completed at least three years of follow-up. RESULTS: Twenty-five patients were included in this study who underwent transabdominal Soave (n = 8), Duhamel (n = 4), and TEPT (n = 13). There were 24 patients with short aganglionosis type. The median age of HSCR diagnosis was 10 (IQR = 1–39) months, while the median age of pull-through surgery was 17 (IQR = 7–47) months. The median follow-up of BFS level for HSCR patients after pull-through was 72 (IQR, 54–99) months. There were 11 patients with good BFS level and 10 patients with normal BFS level. Additionally, 50% of Duhamel patients had poor BFS level, while 50% of Soave patients had good BFS level, and 54% of TEPT patients had normal BFS level (p = 0.027). As many as 50% of Duhamel patients showed daily soiling and required protective aids, while 38.5% of TEPT had staining less than 1/week and no change of underwear required, and 50% of Soave patients revealed no soiling, respectively (p = 0.030). Furthermore, 75% of Duhamel patients had accidents, while 75% of Soave and 46.2% of TEPT patients had no accidents (p = 0.035). CONCLUSION: Our study shows that the type of definitive surgery might affect the long-term bowel functional outcome; particularly, the TEPT approach might have some advantages over the transabdominal Soave and Duhamel procedures.
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spelling pubmed-90630422022-05-04 Long-term functional outcomes of patients with Hirschsprung disease following pull-through Gunadi Monica Carissa, Theodora Stevie Daulay, Ezzah Fatmala Yulianda, Dicky Iskandar, Kristy Dwihantoro, Andi BMC Pediatr Research BACKGROUND: Hirschsprung disease (HSCR) is a common congenital disorder presenting with functional obstruction due to aganglionosis of the colon. There are numerous types of pull-through surgery for managing HSCR, such as transabdominal endorectal (Soave), Swenson, Duhamel, transanal endorectal pull-through (TEPT), and laparoscopic (Georgeson) approach. Here, we aimed to describe the long-term outcome of patients with HSCR who underwent transabdominal Soave, Duhamel, and TEPT in our institution. METHODS: We performed a cross-sectional analysis for patients who underwent Duhamel, Soave, and TEPT at our institution from January 2012 to December 2015. Long-term functional outcome was determined by bowel function score (BFS). The BFS was obtained by interviewing patients who had completed at least three years of follow-up. RESULTS: Twenty-five patients were included in this study who underwent transabdominal Soave (n = 8), Duhamel (n = 4), and TEPT (n = 13). There were 24 patients with short aganglionosis type. The median age of HSCR diagnosis was 10 (IQR = 1–39) months, while the median age of pull-through surgery was 17 (IQR = 7–47) months. The median follow-up of BFS level for HSCR patients after pull-through was 72 (IQR, 54–99) months. There were 11 patients with good BFS level and 10 patients with normal BFS level. Additionally, 50% of Duhamel patients had poor BFS level, while 50% of Soave patients had good BFS level, and 54% of TEPT patients had normal BFS level (p = 0.027). As many as 50% of Duhamel patients showed daily soiling and required protective aids, while 38.5% of TEPT had staining less than 1/week and no change of underwear required, and 50% of Soave patients revealed no soiling, respectively (p = 0.030). Furthermore, 75% of Duhamel patients had accidents, while 75% of Soave and 46.2% of TEPT patients had no accidents (p = 0.035). CONCLUSION: Our study shows that the type of definitive surgery might affect the long-term bowel functional outcome; particularly, the TEPT approach might have some advantages over the transabdominal Soave and Duhamel procedures. BioMed Central 2022-05-03 /pmc/articles/PMC9063042/ /pubmed/35505310 http://dx.doi.org/10.1186/s12887-022-03301-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Gunadi
Monica Carissa, Theodora
Stevie
Daulay, Ezzah Fatmala
Yulianda, Dicky
Iskandar, Kristy
Dwihantoro, Andi
Long-term functional outcomes of patients with Hirschsprung disease following pull-through
title Long-term functional outcomes of patients with Hirschsprung disease following pull-through
title_full Long-term functional outcomes of patients with Hirschsprung disease following pull-through
title_fullStr Long-term functional outcomes of patients with Hirschsprung disease following pull-through
title_full_unstemmed Long-term functional outcomes of patients with Hirschsprung disease following pull-through
title_short Long-term functional outcomes of patients with Hirschsprung disease following pull-through
title_sort long-term functional outcomes of patients with hirschsprung disease following pull-through
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9063042/
https://www.ncbi.nlm.nih.gov/pubmed/35505310
http://dx.doi.org/10.1186/s12887-022-03301-6
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