Ann Surg Treat Res.  2021 Oct;101(4):231-239. 10.4174/astr.2021.101.4.231.

Assessment of defecation function beyond infantile period for transanal single-stage endorectal pull-through in Hirschsprung disease

• Kim SH
• Cho YH
• Kim HY

• KMID: 2520654
• DOI: http://doi.org/10.4174/astr.2021.101.4.231

Abstract

Purpose
Transanal single-stage endorectal pull-through (TERPT) procedure for patients with Hirschsprung disease (HD) has favorable outcomes, with a lower complication rate. Nevertheless, various degrees of bowel dysfunction and fecal incontinence can persist for a long time in some patients. The aim of this study was to assess the mid- and long-term outcomes of TERPT performed during the infantile period after the completion of toilet training.
Methods
We retrospectively reviewed 82 patients aged ≥4 years who underwent TERPT during the infantile period after the pathological diagnosis of HD between 2001 and 2013. Functional outcomes were investigated according to the answers of the Bowel Function Score (BFS) questionnaire, a previously validated 7-item questionnaire about bowel habits. Normal values were obtained in a previous study on BFS for children in Western countries, and a one-sample t-test was used for statistical analysis.
Results
Overall, BFS was similar in all investigated age groups. On comparing fecal soiling and social problems between the HD and normal populations, a lower score at an early age in patients with HD was noted; however, the scores became similar when the patients were 7 years of age. Stool frequency decreased continuously but was not significantly different between the 2 groups.
Conclusion
The functional outcomes of TERPT performed during the infantile period, after completing toilet training, were similar to that of the normal population. In most cases, uncomfortable symptoms were diminished and functions improved with age.

Keyword

Function; Hirschsprung disease; Long-term; Outcome; Transanal single-stage endorectal pull-through procedure

Figure

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  Fig. 1 Average Bowel Function Score (BFS) of the patients who underwent transanal single-stage endorectal pull-through (TERPT) procedure and the normal population. (A) Ability to hold back defecation, (B) feels/reports the urge to defecate, (C) frequency of defecation, (D) fecal soiling, (E) fecal accidents, (F) constipation, (G) social problems, and (H) overall.

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