Abstract
Introduction The objective of this study is to determine short-term complications and evaluate
long-term bowel function, lower urinary tract symptoms, and quality of life (QoL)
in patients treated for Hirschsprung's disease (HSCR) with transanal endorectal pull-though
(TERPT) compared with healthy controls.
Materials and Methods This cross-sectional case–control study included 30 HSCR patients treated with TERPT
in 2006 to 2014 at Karolinska University Hospital, and 30 healthy controls matched
for age and gender. Data on short-term complications were compiled from medical records
and classified according to Clavien-Dindo. Bowel function and QoL were evaluated with
the validated questionnaires bowel function score and KIDSCREEN-52. Lower urinary
tract symptoms were evaluated through an 8-item lower urinary tract symptoms (LUTS)
questionnaire.
Results Six (20%) patients had a short-term postoperative complication according to Clavien-Dindo,
with insufficient pain management being the most common complication. The median age
at follow-up was 7 years (range = 4–11). Median bowel function score was significantly
lower in HSCR patients than in controls, 14 versus 19 (p < 0.001). Twenty-one of the HSCR patients reported impaired bowel function compared
with two of the controls (p < 0.001). The overall prevalence of LUTS was 11 (38%) in the HSCR patients compared
with seven (23%) in the controls (p = 0.751). HSCR patients reported a slightly lower QoL in the KIDSCREEN domain “financial
resources” compared with controls (p = 0.008).
Conclusion According to Clavien-Dindo, short-term postoperative complications occurred in 20%
of the patients. Impaired bowel function persists throughout childhood for most HSCR
patients. The prevalence of LUTS and QoL is not affected in HSCR patients compared
with controls.
Keywords
Hirschsprung's disease - complications - bowel function - quality of life
