Development of Frequency of Stools over Time in Children with Hirschsprung Disease Posttransanal Endorectal One-Stage Pull-through
25 November 2013
27 March 2014
28 May 2014 (online)
Background The transanal endorectal one-stage pull-through (TERPT) procedure in children with Hirschsprung disease (HD) is frequently used worldwide. To give the children's families realistic expectations and to plan the medical care for the period after TERPT, the outcome is of great importance.
Aim The aim of this article is to collect information on the number of stools passed daily after one-stage TERPT procedure for HD.
Patients and Methods A prospective follow-up study for collecting information on the outcome of planned TERPT from 2005 through 2012 was performed. A control group consisting of age and gender matched children was used.
Results The results show an initial high frequency of daily stools, median 12 stools/day (range, 3–30 stools/day), reaching an acceptable situation with median 4 stools/day (range, 0–10 stools/day) after 1 year. After 4 years, the number of stools did not differ significantly from healthy controls.
Conclusion This study shows that it takes 4 years after TERPT before the number of stools becomes normalized. To compare the long-term outcome, it would be desirable to have uniform regular reports on the daily frequency of passed stools, incontinence, and constipation during the years after TERPT.
- 1 De la Torre-Mondragón L, Ortega-Salgado JA. Transanal endorectal pull-through for Hirschsprung's disease. J Pediatr Surg 1998; 33 (8) 1283-1286
- 2 Levitt MA, Martin CA, Olesevich M, Bauer CL, Jackson LE, Peña A. Hirschsprung disease and fecal incontinence: diagnostic and management strategies. J Pediatr Surg 2009; 44 (1) 271-277 , discussion 277
- 3 Zhang SC, Bai YZ, Wang W, Wang WL. Stooling patterns and colonic motility after transanal one-stage pull-through operation for Hirschsprung's disease in children. J Pediatr Surg 2005; 40 (11) 1766-1772
- 4 Rintala RJ, Pakarinen MP. Long-term outcomes of Hirschsprung's disease. Semin Pediatr Surg 2012; 21 (4) 336-343
- 5 Romero P, Kroiss M, Chmelnik M, Königs I, Wessel LM, Holland-Cunz S. Outcome of transanal endorectal vs. transabdominal pull-through in patients with Hirschsprung's disease. Langenbecks Arch Surg 2011; 396 (7) 1027-1033
- 6 Stensrud KJ, Emblem R, Bjørnland K. Functional outcome after operation for Hirschsprung disease—transanal vs transabdominal approach. J Pediatr Surg 2010; 45 (8) 1640-1644
- 7 Ortiz-Rubio I, Pérez-Aguilera M, Granéli C, Stenstrüm P, Arnbjürnsson E. Literature review of the outcome after one-stage transanal endorectal pull-through procedure for hirschsprung's disease in children. Surgical Science 2013; 4: 258-262
- 8 Örnö Ax S, Arnbjörnsson E, Gisselsson-Nord D. A comparison of rectal suction and full wall biopsy in hirschsprung's disease. Surgical Science 2014; 5: 15-19
- 9 Vult von Steyern K, Wingren P, Wiklund M, Stenström P, Arnbjörnsson E. Visualisation of the rectoanal inhibitory reflex with a modified contrast enema in children with suspected Hirschsprung disease. Pediatr Radiol 2013; 43 (8) 950-957
- 10 Pena A. Postop care, complications, and results. In: Pena A. Atlas of Surgical Management of Anorectal Malformations. 1st ed. New York, NY: Springer Verlag; 1990: 91-95
- 11 Chatoor D, Emmnauel A. Constipation and evacuation disorders. Best Pract Res Clin Gastroenterol 2009; 23 (4) 517-530
- 12 Ruttenstock E, Puri P. Systematic review and meta-analysis of enterocolitis after one-stage transanal pull-through procedure for Hirschsprung's disease. Pediatr Surg Int 2010; 26 (11) 1101-1105
- 13 Malone PS, Ransley PG, Kiely EM. Preliminary report: the antegrade continence enema. Lancet 1990; 336 (8725) 1217-1218
- 14 Aworanti OM, Mcdowell DT, Martin IM, Hung J, Quinn F. Comparative review of functional outcomes post surgery for Hirschsprung's disease utilizing the paediatric incontinence and constipation scoring system. Pediatr Surg Int 2012; 28 (11) 1071-1078
- 15 Yanchar NL, Soucy P. Long-term outcome after Hirschsprung's disease: patients' perspectives. J Pediatr Surg 1999; 34 (7) 1152-1160
- 16 Teitelbaum DH, Cilley RE, Sherman NJ , et al. A decade of experience with the primary pull-through for hirschsprung disease in the newborn period: a multicenter analysis of outcomes. Ann Surg 2000; 232 (3) 372-380
- 17 Kim HY, Oh J-T. Stabilization period after 1-stage transanal endorectal pull-through operation for Hirschsprung disease. J Pediatr Surg 2009; 44 (9) 1799-1804
- 18 Zhang SC, Bai YZ, Wang W, Wang WL. Clinical outcome in children after transanal 1-stage endorectal pull-through operation for Hirschsprung disease. J Pediatr Surg 2005; 40 (8) 1307-1311
- 19 Van Leeuwen K, Geiger JD, Barnett JL, Coran AG, Teitelbaum DH. Stooling and manometric findings after primary pull-throughs in Hirschsprung's disease: Perineal versus abdominal approaches. J Pediatr Surg 2002; 37 (9) 1321-1325
- 20 Lopera C, Stenström P, Anderberg M, Arnbjürnsson E. Literature review of the frequency of reoperations after one stage transanal endorectal pull-through procedure for hirschsprung's disease in children. Surgical Science 2012; 3 (6) 290-294
- 21 Gunnarsdóttir A, Larsson LT, Arnbjörnsson E. Transanal endorectal vs. Duhamel pull-through for Hirschsprung's disease. Eur J Pediatr Surg 2010; 20 (4) 242-246
- 22 Tresca AJ. Normal bowel movements. Every person is different when it comes to bowel movements. Available at: http://ibdcrohns.about.com/od/dailylife/a/normalbm.htm [Updated March 19, 2014]