Abstract
BackgroundSeveral pull-through procedures have been described for Hirschsprung disease (HSCR) with varying functional outcomes. The voluntary bowel movement (VBM) and the absence of soiling or constipation after pull-through remain the most important markers of good outcome. We aimed to compare the functional outcomes in HSCR patients following Soave and Duhamel procedures.MethodsKrickenbeck classification was utilized to determine VBM, soiling and constipation for patients who underwent Soave and Duhamel pull-through at Dr. Sardjito Hospital, Indonesia from 2013 to 2016.ResultsFifty-three patients were ascertained (Soave: 23 males and 2 females vs. Duhamel: 22 males and 6 females, p = 0.26). Ninety-three and 88% patients had a VBM following Duhamel and Soave pull-through, respectively (p = 0.66). Constipation frequency was significantly higher in Soave than Duhamel groups (24% vs. 4%; p = 0.04) with OR of 8.5 (95% CI = 1.0–76.7), whereas soiling rate was similar between Duhamel (21%) and Soave (8%) groups (p = 0.26). Furthermore, the risk of constipation was increased ~ 21.7-fold in female patients after Soave procedure and was almost statistically significant (p = 0.05).ConclusionsThe constipation rate is higher in patients who underwent Soave than Duhamel procedure, but the VBM and soiling frequencies are similar. The constipation risk following Soave pull-through might be increased by the female gender. Furthermore, a multicenter study with a larger sample of patients is necessary to clarify and confirm our findings.
Highlights
Several pull-through procedures have been described for Hirschsprung disease (HSCR) with varying functional outcomes
We used ICD-10 codes (International Statistical Classification of Diseases and Related Health Problems, 10th Revision) (Q43.1: Hirschsprung disease) to identify patients diagnosed with HSCR and examined 65 medical records
None of the clinical characteristics of HSCR patients showed any difference between the two surgical methods (Table 1)
Summary
Several pull-through procedures have been described for Hirschsprung disease (HSCR) with varying functional outcomes. We aimed to compare the functional outcomes in HSCR patients following Soave and Duhamel procedures. Hirschsprung disease (HSCR) is caused by the migration failure of neural crest cells during intestinal development, resulting in an aganglionic colon and causing a functional obstruction in children [1, 2]. According to the length of aganglionosis, HSCR can be classified as follows: 1) short-segment, 2) long-segment, and 3) total colonic aganglionosis (TCA), with a male-to-female ratio of approximately 4:1 [1]. The goal of HSCR treatment is surgical resection of the aganglionic bowel and pulling the ganglionated bowel through to a point just above the dentate line [3].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
