Department of Pediatric Surgery, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
Department of Pediatric Surgery, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
J Pediatr Surg. 2020 Nov;55(11):2375-2378. doi: 10.1016/j.jpedsurg.2020.04.010. Epub 2020 May 19.
The reported functional outcome in patients operated with transanal endorectal pull-through (ERPT) for Hirschsprung disease (HD) varies greatly. Some studies suggest better functional outcome in older than in younger HD patients, but there are almost no longitudinal studies that have demonstrated such improvement. Therefore, we aimed to compare functional outcome in a cohort of HD patients over time to assess whether bowel function improves with increasing age.
Functional outcome in HD patients operated with ERPT from 1998 to 2007 was recorded by standardized interviews by an independent investigator during 2008-2011 and again in 2017/2018. Bowel function was assessed using the Krickenbeck questionnaire. Clinical data were collected prospectively.
50 of the original 62 patients responded for a second interview. Median age at the two interviews was 8,1 (3,4-16,6) and 15,4 (9,9-25) years respectively. There was no difference in the rate of soiling at first (52%) and second (52%) follow-up. Constipation was reported in 20% of the patients at first, and in 24% at second follow-up. Bowel management was used by 30% and 32% at first and second interview respectively.
Soiling and constipation are common in HD patients several years after surgery, and no improvement of bowel function with increasing age could be demonstrated.
Level II.
经肛门内直肠黏膜切除术（ERPT）治疗先天性巨结肠（HD）患者的报告功能结果差异很大。一些研究表明，老年 HD 患者的功能结果优于年轻患者，但几乎没有纵向研究证明有这种改善。因此，我们旨在比较一段时间内 HD 患者的功能结果，以评估肠道功能是否随年龄增长而改善。
通过独立研究者于 2008-2011 年期间进行的标准化访谈，以及于 2017/2018 年再次进行的访谈，记录了 1998 年至 2007 年接受 ERPT 手术的 HD 患者的功能结果。使用 Krickenbeck 问卷评估肠道功能。临床数据是前瞻性收集的。
50 名原始 62 名患者中的 50 名对第二次访谈做出了回应。两次访谈的中位年龄分别为 8.1（3.4-16.6）和 15.4（9.9-25）岁。首次（52%）和第二次（52%）随访时的污染率没有差异。首次随访时，20%的患者报告存在便秘，而第二次随访时则为 24%。首次和第二次随访时，分别有 30%和 32%的患者使用肠道管理。
在手术后数年，HD 患者经常出现污染和便秘，并且随着年龄的增长，肠道功能没有改善的迹象。
二级。
