Hirschprung´s disease is uncommon in children and causes a variety of problems, not only for the pediatric surgeon but also for the patients and their family. Several surgical techniques have been described with different results among them.
Objective: To review the functional outcome after different surgical procedures in our series. Methods: A retrospective study of patients at our Institution between 2000 and 2013 that had biopsies compatible with Hirschprung’s Disease. Data was analyzed based on age at debut or surgical technique. For the functional outcome analysis, six patients were excluded as three did not have a complete surgical solution (pull through or ostomy closure pending) and the other three no recorded postoperative clinical data .
Results: Data of 42 patients with biopsies compatible with Hirschprung’s Disease was analyzed. The series was divided in two groups as determined by their age at onset: Group 1 (69%) was constituted by neonatal patients and Group 2 (31%) consisted of patients with onset after 1 month since birth. An urgent surgery was required in 45% of the total cases. After the pull through procedure, the series showed 35.7% patients had early complications and 54.7% patients has late complications (including but not limited to enterocolitis, spoiling, and constipation). Also, functional results were evaluated both by the surgeon’s clinical observation in the last control and by conducting a telephone survey where the patient’s guardian was polled using a PCISS score. Patients that underwent a Georgeson’s pull through showed less long term complications and a better functionality after the first year post surgery as compared to those who underwent De La Torre’s procedure, yet the difference is not significant (p=1.00). During the last control, 57,4% of our series had an adequate functional result.
Conclusion: The use of functional evaluation protocols in surgical patients with Hirschprung’s Disease allowed us to obtain objective results of our surgical procedures. |
