Long-Term Outcomes and Quality of Life in Patients after Soave Pull-Through Operation for Hirschsprung's Disease: An Observational Retrospective Study.
| Autor: | Tran VQ; Department of Pediatric Surgery, City Children's Hospital, Ho Chi Minh City, Vietnam.; Hôpital Universitaire des Enfants Reine Fabiola, Bruxelles, Belgique - Université Libre de Bruxelles (ULB), Brussels, Belgium., Mahler T; Department of Gastroenterology, Hôpital Universitaire des Enfants Reine Fabiola, Bruxelles, Belgique - Université Libre de Bruxelles (ULB), Brussels, Belgium., Dassonville M; Hôpital Universitaire des Enfants Reine Fabiola, Bruxelles, Belgique - Université Libre de Bruxelles (ULB), Brussels, Belgium., Truong DQ; Department of Pediatric Surgery, City Children's Hospital, Ho Chi Minh City, Vietnam., Robert A; Faculté de santé publique, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain (UCL), Brussels, Belgium., Goyens P; Laboratory of Pediatrics, Université Libre de Bruxelles (ULB), Brussels, Belgium., Steyaert H; Hôpital Universitaire des Enfants Reine Fabiola, Bruxelles, Belgique - Université Libre de Bruxelles (ULB), Brussels, Belgium. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie [Eur J Pediatr Surg] 2018 Oct; Vol. 28 (5), pp. 445-454. Date of Electronic Publication: 2017 Jul 24. |
| DOI: | 10.1055/s-0037-1604115 |
| Abstrakt: | Introduction: Patients after pull-through operation for Hirschsprung's disease (HD) are at high risk of defecation disorders. This study aimed at investigating their long-term outcomes and quality of life (QoL) in comparison with controls. Patients and Methods: Patients older than 5 years operated on for HD were interviewed to complete detailed questionnaires on bowel function. Patients without neurologic impairment were enrolled in a QoL survey to compare with controls matched for sex and age and selected randomly from the general population using sampling set in a ratio of four controls to one case of HD. Results: In total, 53 operated patients were enrolled. Mean age of the patients was 16 ± 8 years, with 68% boys. Rectosigmoid aganglionosis was the most seen form of HD in 38 (72%) cases. Open Soave was performed in 40 (75.5%) cases, and minimally invasive surgery Soave (MIS Soave) in 13 (24.5%) cases. At investigation, prevalence of fecal incontinence and constipation were 22.6 and 13.2%, respectively. Regarding QoL survey, 45 patients and 180 controls were enrolled, excluding 8 patients with neurologic impairment. Thirty-seven (82.2%) patients were classified as having a good QoL (score ≥ 9 points); whereas six had a fair QoL (5-8 points) and two had a poor QoL (< 5 points). QoL score in the cases and the controls were 10.2 ± 2.5 and 11.9 ± 0.4 points, respectively. Long aganglionosis form of HD was significantly associated with a low QoL (score < 8 points), adjusted odds ratio = 9, 95% confidence interval [1.3; 64.1] ( p < 0.05). In subscales analyses, the prevalence of each dimension including fecal continence, school absenteeism, unhappiness or anxiety, food restriction, and peer rejection was significantly higher in operated patients than in controls ( p <0.001). Conclusion: Although the QoL of patients operated on for HD in general was with good outcomes, fecal incontinence and constipation still are problematic issues and challenges in a high percentage of patients. Therefore, a long-term and multidisciplinary follow-up is essentially required for these patients. Competing Interests: None. (Georg Thieme Verlag KG Stuttgart · New York.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|