Long-term growth outcomes in children with Hirschsprung disease after definitive surgery: A cross-sectional study

Background: The growth of children with Hirschsprung disease (HSCR) can be affected by many factors, including
the environment, nutrient intake, and surgery. Our study compared the long-term (i.e., at least 3 years of followup)
growth outcomes in HSCR children after transabdominal Soave and Duhamel and transanal endorectal pullthrough
(TEPT) surgeries.
Methods: A cross-sectional study was conducted in children <18 years of age diagnosed histopathologically with
HSCR who underwent pull-through between January 1, 2012–December 31, 2015 in our institution. The postoperative
anthropometric data were obtained prospectively through interviews during the outpatient clinic
appointment or by telephone.
Results: We recruited 21 patients (Soave: 7 vs. Duhamel: 4 vs. TEPT: 10; p = 0.06). There were no significant
differences between the three surgical methods in terms of preoperative and postoperative nutritional status
categories (p = 0.52). Concerning the changes in nutritional status, after Soave surgery, it was improved, steady,
and worsened in 28.6%, 57.1%, and 14.3% of the children, respectively. The nutritional status of the Duhamel
group was worsened and steady in 25% and 75% of the children, respectively, while in the TEPT group, it was
improved and steady in 40% and 60% of the children, respectively. However, these differences were not statistically
significant (p = 0.42).
Conclusions: While some HSCR children show an improvement in their nutritional status after Soave and TEPT
procedures, the overall nutritional status is similar among different procedures. Further multicenter studies with
a larger sample size are important to clarify our findings