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A Nordic multicente...
A Nordic multicenter survey of long-term bowel function after transanal endorectal pull-through in 200 patients with rectosigmoid Hirschsprung disease
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- Bjørnland, Kristin (author)
- University of Oslo
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- Pakarinen, Mikko P (author)
- University of Helsinki
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- Stenstrøm, Pernilla (author)
- Lund University,Lunds universitet,Barnkirurgi,Forskargrupper vid Lunds universitet,Pediatric surgery,Lund University Research Groups,Skåne University Hospital
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- Stensrud, Kjetil J (author)
- University of Oslo
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- Neuvonen, Malla (author)
- University of Helsinki
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- Granström, Anna L (author)
- Karolinska Institutet
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- Graneli, Christina (author)
- Lund University,Lunds universitet,Barnkirurgi,Forskargrupper vid Lunds universitet,Pediatric surgery,Lund University Research Groups,Skåne University Hospital
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- Pripp, Are H (author)
- Oslo university hospital
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- Arnbjörnsson, Einar (author)
- Lund University,Lunds universitet,Barnkirurgi,Forskargrupper vid Lunds universitet,Pediatric surgery,Lund University Research Groups,Skåne University Hospital
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- Emblem, Ragnhild (author)
- University of Oslo
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- Wester, Tomas (author)
- Karolinska Institutet
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- Rintala, Risto J (author)
- University of Helsinki
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(creator_code:org_t)
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- Elsevier BV, 2017
- 2017
- English.
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In: Journal of Pediatric Surgery. - : Elsevier BV. - 1531-5037 .- 0022-3468. ; 52:9, s. 1458-1464
- Related links:
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http://dx.doi.org/10...
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https://helda.helsin...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
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- OBJECTIVE: Transanal endorectal pull-through (ERPT) is the most popular technique to treat Hirschsprung disease (HD). Still, there is limited knowledge on long-term bowel function. This cross-sectional, multicenter study assessed long-term bowel function in a large HD population and examined predictors of poor outcome.METHODS: Patients older than four years or their parents filled out a validated questionnaire on bowel function. Clinical details were recorded retrospectively from medical records.RESULTS: 73/200 (37%) patients reported absolutely no impaired bowel function, meaning no constipation, fecal accidents, stoma, appendicostomy or need for enemas. Seven (4%) had a stoma, and 33 (17%) used antegrade or rectal colonic enemas. Most disarrangements of fecal control and constipation were significantly less common in older age group, but abnormal defecation frequency and social problems remained unchanged. Syndromic patients (n=31) experienced frequent fecal accidents (46%) more often than nonsyndromic (14%, P<0.001). Having a syndrome (adjusted OR 5.6, 95% CI 2.1-15, P=0.001) or a complete transanal ERPT (adjusted OR 2.4, 95% CI 1.1-5.7, P=0.038) was significantly associated with poor outcome defined as having a stoma, an appendicostomy, daily fecal accidents or need of regular rectal wash outs.CONCLUSION: A significant number of HD patients experience bowel problems many years after definite surgery. Fecal control was significantly better in older than younger HD patients, but some continued to have considerable bowel problems also as adults. A total transanal ERPT was associated with poorer outcome. Long-term follow-up of HD patients is warranted. Prognosis Study: Level II.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
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- art (subject category)
- ref (subject category)
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- By the author/editor
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Bjørnland, Krist ...
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Pakarinen, Mikko ...
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Stenstrøm, Perni ...
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Stensrud, Kjetil ...
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Neuvonen, Malla
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Granström, Anna ...
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Graneli, Christi ...
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Pripp, Are H
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Arnbjörnsson, Ei ...
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Emblem, Ragnhild
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Wester, Tomas
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Rintala, Risto J
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Gastroenterology ...
- Articles in the publication
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Journal of Pedia ...
- By the university
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Lund University
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Karolinska Institutet