Long‐term functional outcomes and quality of life in patients with Hirschsprung’s disease. BJS 2019; 106: 499-507.
Published: 17th January 2019
Authors: R. J. Meinds, A. F. W. van der Steeg, C. E. J. Sloots, M. J. Witvliet, I. de Blaauw, W. G. van Gemert et al.
It is unclear whether functional outcomes improve or deteriorate with age following surgery for Hirschsprung's disease. The aim of this cross‐sectional study was to determine the long‐term functional outcomes and quality of life (QoL) in patients with Hirschsprung's disease.
Patients with pathologically proven Hirschsprung's disease older than 7 years were included. Patients with a permanent stoma or intellectual disability were excluded. Functional outcomes were assessed according to the Rome IV criteria using the Defaecation and Faecal Continence questionnaire. QoL was assessed by means of the Child Health Questionnaire Child Form 87 or World Health Organization Quality of Life questionnaire 100. Reference data from healthy controls were available for comparison.
Of 619 patients invited, 346 (55·9 per cent) responded, with a median age of 18 (range 8–45) years. The prevalence of constipation was comparable in paediatric and adult patients (both 22·0 per cent), and in patients and controls. Compared with controls, adults with Hirschsprung's disease significantly more often experienced straining (50·3 versus 36·1 per cent; P = 0·011) and incomplete evacuation (47·4 versus 27·2 per cent; P < 0·001). The prevalence of faecal incontinence, most commonly soiling, was lower in adults than children with Hirschsprung's disease (16·8 versus 37·6 per cent; P < 0·001), but remained higher than in controls (16·8 versus 6·1 per cent; P = 0·003). Patients with poor functional outcomes scored significantly lower in several QoL domains.
This study has shown that functional outcomes are better in adults than children, but symptoms of constipation and soiling persist in a substantial group of adults with Hirschsprung's disease. The persistence of defaecation problems is an indication that continuous care is necessary in this specific group of patients.Full text
You may also be interested in
Authors: R. L. Venchiarutti, M. J. Solomon, C. E. Koh, J. M. Young, D. Steffens
Meta‐analysis of the role of colonoscopy after an episode of left‐sided acute diverticulitis. BJS 2019; 106: 988-997.
Authors: S. J. Rottier, S. T. Dijk, A. A. W. Geloven, W. H. Schreurs, W. A. Draaisma, W. A. Enst et al.
Randomized clinical trial
Multicentre randomized clinical trial of colonic J pouch or straight stapled colorectal reconstruction after low anterior resection for rectal cancer.
Authors: S. Pucciarelli, P. Del Bianco, U. Pace, F. Bianco, A. Restivo, I. Maretto et al.
Authors: T. O. Sillo, A. D. Beggs, D. G. Morton, G. Middleton
Meta‐analysis of the effect of extending the interval after long‐course chemoradiotherapy before surgery in locally advanced rectal cancer.
Authors: É. J. Ryan, D. P. O'Sullivan, M. E. Kelly, A. Z. Syed, P. C. Neary, P. R. O'Connell et al.
Randomized clinical trial
Randomized clinical trial of accelerated enhanced recovery after minimally invasive colorectal cancer surgery (RecoverMI trial).
Authors: B. K. Bednarski, T. P. Nickerson, Y. N. You, C. A. Messick, B. Speer, V. Gottumukkala et al.
Organoids from colorectal peritoneal metastases as a platform for improving hyperthermic intraperitoneal chemotherapy.
Authors: I. Ubink, A. C. F. Bolhaqueiro, S. G. Elias, D. A. E. Raats, A. Constantinides, N. A. Peters et al.
Postoperative complications in relation to overall treatment time in patients with rectal cancer receiving neoadjuvant radiotherapy.
Authors: J. Erlandsson, D. Pettersson, B. Glimelius, T. Holm, A. Martling
Immunogenomic profiles associated with response to neoadjuvant chemoradiotherapy in patients with rectal cancer.
Authors: T. Akiyoshi, N. Tanaka, K. Kiyotani, O. Gotoh, N. Yamamoto, K. Oba et al.
BRAF mutation is not associated with an increased risk of recurrence in patients undergoing resection of colorectal liver metastases.
Authors: J.‐B. Bachet, N. Moreno‐Lopez, L. Vigano, U. Marchese, M. Gelli, L. Raoux et al.
Propensity score‐matched analysis of oncological outcome between stent as bridge to surgery and emergency resection in patients with malignant left‐sided colonic obstruction. BJS 2019; 106: 1075-1086.
Authors: F. J. Amelung, W. A. A. Borstlap, E. C. J. Consten, J. V. Veld, E. E. van Halsema, W. A. Bemelman et al.
Systematic review of outcomes after total neoadjuvant therapy for locally advanced rectal cancer. BJS 2019; 106: 979-987.
Authors: A. Zaborowski, A. Stakelum, D. C. Winter