Laparoscopic-assisted pull-through for Hirschsprung's disease, a prospective repeated evaluation of functional outcome.

[hirschsprung disease]

To evaluate the functional outcome of laparoscopic-assisted endorectal pull-through (LAP ) for Hirschsprung 's disease (HSCR ) over time .Thirty -five children with HSCR underwent laparoscopic-assisted pull-through at our institution between 1998 and 2009 . The diagnosis was histologically confirmed in all cases . Clinical data was extracted from the case records . A prospective assessment of the functional outcome was performed in 2009 and 2012 . Exclusion criteria were a follow-up of less than 6 months after treatment (1 case ) and total colonic aganglionosis (1 case ). An independent examiner , not involved in the clinical care of the patients , performed interviews using a semi-structured questionnaire . Four patients could not be traced for the first interview . Two cases were lost for the second interview . Altogether twenty-seven patients completed the study . Data from the two interviews were compared . The regional ethical review board approved the study .The median patient age was 4 years old (range 2 -16 ) at the time of the first interview and 7 years old (range 5 -19 ) at the time of the second interview . There were 23 males and 4 females in the study group . The median age at laparoscopic-assisted pull-through was 104 days old (range 29 days -8 years ). In the first interview 11 patients reported constipation , 18 patients reported soiling more frequently than once per week when they had loose stools and 16 patients when they had solid stools . Laxatives or irrigations were used by 13 of the patients . In the second interview 4 patients reported constipation , 16 patients reported soiling when they had loose stools and 15 patients reported soiling when they had solid stools . Eight patients used laxatives or irrigations . The decrease in constipation was statistically significant (p =0 ,023 ).Our study shows a statistically significant reduction of constipation over time . There is a high risk of incontinence after laparoscopic-assisted pull-through , with few signs of short -term improvement .

Diseases
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Diseases presenting "7 years old" symptom

hirschsprung disease

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