| Total colonic Hirschsprung's disease: a 28-year experience. | |
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MedLine Citation:
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PMID: 15868586 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The aim of this study was to review outcomes after surgical treatment of total colonic Hirschsprung's disease (TCH). METHODS: Twenty-five records of patients with TCH treated between 1974 and 2002 were reviewed. Follow-up data were collected using a standardized questionnaire. Objective functional outcome was assessed using a scoring system. RESULTS: Twenty patients had aganglionosis of the colon and distal ileum, 5 of whom had a more extensive condition. One of these 5 patients underwent an endorectal pull-through (ERPT), 1 underwent intestinal transplantation, and 3 died. Four of the remaining 20 patients underwent a primary ERPT, 16 received a stoma as neonates followed by ERPT in 12, and a Martin-Duhamel procedure or Swenson's operation in 3 (median age, 10.5 months); 1 remains with an ostomy. Postoperative complications included enterocolitis (55%), anal stricture (25%), and perineal excoriation (20%). Mean follow-up were 17.5 years (+/-11.1 years). Eighty-nine percent were free of recurrent enterocolitis. Frequency of bowel movements is 1 to 5 per day in 82% of the patients, 18% have 6 or more bowel movements per day. Occasional soiling is noted in 40% (one third of those requiring nighttime diapers). Overall functional outcome was good in 83%. Those patients with the longest follow-up periods had the best stooling scores (P = .04). CONCLUSIONS: Surgical treatment of TCH is associated with a number of complications including recurrent enterocolitis and anal strictures. Long-term outcome is quite favorable. |
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Authors:
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Barbara E Wildhaber; Daniel H Teitelbaum; Arnold G Coran |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of pediatric surgery Volume: 40 ISSN: 1531-5037 ISO Abbreviation: J. Pediatr. Surg. Publication Date: 2005 Jan |
Date Detail:
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Created Date: 2005-05-03 Completed Date: 2006-06-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0052631 Medline TA: J Pediatr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 203-6; discussion 206-7 Citation Subset: IM |
Affiliation:
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Section of Pediatric Surgery, CS Mott Children's Hospital, University of Michigan Medical School, Health System, Ann Arbor, MI 48109-0245, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anastomosis, Surgical Anus Diseases / etiology Constriction, Pathologic Digestive System Surgical Procedures / adverse effects* Enterocolitis / etiology Fecal Incontinence / etiology Female Follow-Up Studies Hirschsprung Disease / surgery* Humans Infant Infant, Newborn Male Perineum Postoperative Complications Recovery of Function Retrospective Studies Skin Diseases / etiology Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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