Functional outcomes of patients with short-segment Hirschsprung disease after transanal endorectal pull-through

Gunadi, Gunadi and Ivana, Gabriele and Mursalin, Desyifa Annisa and Pitaka, Ririd Tri and Zain, Muhammad Wildan and Puspitarani, Dyah Ayu and Afandy, Dwiki and Simanjaya, Susan and Dwihantoro, Andi and Makhmudi, Akhmad (2021) Functional outcomes of patients with short-segment Hirschsprung disease after transanal endorectal pull-through. BMC Gastroenterology, 21 (1). ISSN 1471230X

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Abstract

Background: Transanal endorectal pull-through (TEPT) is considered the most preferable treatment method for Hirschsprung disease (HSCR) since it is less invasive and has fewer morbidities than transabdominal pull-through. Here, functional outcomes in short-segment HSCR patients after TEPT were assessed and associated with the prognostic factors. Methods: Krickenbeck classification was used to assess the functional outcomes in patients with HSCR after TEPT surgery at our institution from 2012 to 2020. Results: Fifty patients were involved in this study. Voluntary bowel movement (VBM) was achieved in 82 of subjects. Nine (18) subjects had soiling grade 1, while two (4) and two (4) patients suffered constipation that was manageable with diet and laxative agents, respectively. Patients who underwent TEPT at ≥ 4 years old tended to have soiling more than patients who underwent TEPT at < 4 years old (OR = 16.47 95% CI 0.9–301.61; p = 0.06), whereas patients with post-operative complications had 10.5-fold higher risk for constipation than patients without post-operative complications (p = 0.037; 95% CI 1.15–95.92). Multivariate analysis showed male sex was significantly associated with VBM (OR = 9.25 95% CI 1.34–63.77; p = 0.024), while post-operative complications were strongly correlated with constipation (OR = 10 95% CI 1.09–91.44; p = 0.04). Conclusions: The functional outcomes of HSCR patients after TEPT in our institution are considered relatively good. Moreover, the VBM, soiling, and constipation risk after TEPT might be affected by sex, age at TEPT performed, and post-operative complications, respectively, while the age at TEPT performed might not be associated with functional outcomes. Further multicenter studies with a larger sample size are necessary to clarify and confirm our findings. © 2021, The Author(s).

Item Type: Article
Additional Information: Cited by: 6; All Open Access, Gold Open Access, Green Open Access
Uncontrolled Keywords: Anal Canal; Child, Preschool; Digestive System Surgical Procedures; Hirschsprung Disease; Humans; Infant; Male; Postoperative Complications; Rectum; Retrospective Studies; Treatment Outcome; laxative; Article; child; clinical article; clinical assessment; clinical feature; clinical outcome; constipation; controlled study; correlational study; diet therapy; disease association; female; gastrointestinal motility; high risk patient; Hirschsprung disease; human; male; nutritional status; postoperative care; prognosis; retrospective study; surgical risk; transanal endoscopic surgery; abdominal surgery; adverse event; anal canal; infant; postoperative complication; preschool child; rectum; treatment outcome
Subjects: R Medicine > RB Biomedical Sciences
Divisions: Faculty of Medicine, Public Health and Nursing > Biomedical Sciences
Depositing User: Sri JUNANDI
Date Deposited: 28 Sep 2024 06:39
Last Modified: 28 Sep 2024 06:39
URI: https://ir.lib.ugm.ac.id/id/eprint/4455

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