Long-term outcomes in Hirschsprung disease patients were becoming more well understood. Nonetheless, the disparities in results based on aganglionic lengths remained unknown. For a study, researchers determined that long-term bowel function and general quality of life were evaluated in patients with Hirschsprung with complete colonic or long-segment aganglionosis vs rectosigmoid aganglionosis.
Participants in this countrywide cross-sectional research with established Hirschsprung disease completed the Defecation and Fecal Continence questionnaire, as well as the Child Health Questionnaire Child Form-87 or the WHO Quality of Life-100. Researchers omitted patients who were deceased, under the age of eight, resided abroad, had a chronic enterostomy, or were mentally retarded.
The study population (n=334) had rectosigmoid (83.9%), long-segment (8.7%), or complete colonic aganglionosis operated on (7.5%). Fecal incontinence, in general, did not differ substantially across the 3 groups, but liquid fecal incontinence was linked with complete colonic aganglionosis (odds ratio [OR] = 6.00, 95% CI: 2.07–17.38, P=0.001). In terms of constipation, patients with complete colonic or long-segment aganglionosis were less likely than the rectosigmoid group (OR=0.21, 95% CI, 0.05–0.91, P=0.038 and OR=0.11, 95% CI, 0.01–0.83, P=0.032). Except for a lower physical score in children with complete colonic aganglionosis (P=0.016), the quality of life was comparable across the 3 groups.
Patients with Hirschsprung with complete colonic or long-segment aganglionosis did not have worse fecal incontinence in general with time. The relationship between liquid fecal incontinence and complete colonic aganglionosis and constipation in patients with rectosigmoid aganglionosis might be explained by a variation in stool consistency. Despite the disparities, when it came to maturity, the general quality of life was comparable.
Reference:journals.lww.com/jpgn/Fulltext/2022/03000/Functional_Outcomes_After_Surgery_for_Total.9.aspx
