Development of Frequency of Stools over Time in Children with Hirschsprung Disease Posttransanal Endorectal One-Stage Pull-through

Granéli, Christina; Stenström, Pernilla; Börjesson, Anna; Arnbjörnsson, Einar

doi:10.1055/s-0034-1376396

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…Transanal endorectal pull-through (TERPT) has become one of the most common surgical procedures for HD in recent decades [3]. Both short-term outcomes after TERPT, such as anastomotic leakage, bowel obstruction, and perineal excoriation, and long-term outcomes regarding bowel function have been evaluated in gender-mixed groups [4–8]. …”

Section: Introductionmentioning

confidence: 99%

Diagnosis, Symptoms, and Outcomes of Hirschsprung’s Disease from the Perspective of Gender

Granéli

Dahlin

Börjesson

et al. 2017

Surgery Research and Practice

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Background/Aim. Hirschsprung's disease (HD) has a skewed gender distribution, with a female to male ratio of 1 : 4. This study aims to examine differences between boys and girls with HD regarding preoperative features and postoperative treatment and outcome. Method. The first part of the study was conducted as a retrospective review of all HD patients who underwent transanal endorectal pull-through (TERPT). Pre-, peri-, immediate post-, and first-year postoperative data were collected. The second part was conducted as an observational cross-sectional study by comparing bowel function scores (BFS) determined by structured interviews of patients 4 years old and older. Results. Included were 39 boys and 12 girls. Of these, 25 boys and 9 girls were older than 4 years and participated in the BFS interview. Boys had a higher frequency of hospitalizations during the first postoperative year compared to girls (n = 20 and n = 2, p < 0.05). At long-term follow-up, more boys reported abnormal frequency of defecation, 16 compared to 2 (p < 0.05). There was no difference between genders in terms of preoperative symptoms and overall bowel function later. Conclusion. Boys with HD had more hospitalizations and a higher rate of abnormal frequency of defecation than girls with HD.

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Section: Introductionmentioning

confidence: 99%

Diagnosis, Symptoms, and Outcomes of Hirschsprung’s Disease from the Perspective of Gender

Granéli

Dahlin

Börjesson

et al. 2017

Surgery Research and Practice

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“…Even though constipation was more common among CHD patients, the constipation reported in both groups was mostly mild or laxative-controlled, rather than being severe. The rate of constipation has been reported to vary between 8 and 30% in children with HD operated on with TERPT but then without any analysis of frequencies of CHD in the cohorts [4, 5, 16, 17]. There are no reports on constipation rates in children with CHD, without HD, and therefore it is difficult to tell if this is a symptom of special concern in HD-patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment and Patient Reported Outcome in Children with Hirschsprung Disease and Concomitant Congenital Heart Disease

Hasserius

Hedbys

Granéli

et al. 2017

BioMed Research International

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Purpose. Congenital heart disease (CHD) is reported to be associated with Hirschsprung disease (HD). The aim was to evaluate any differences between children with HD with and without CHD, respectively, with regard to patient characteristics, medical care, and patient reported bowel function. Method. This is a retrospective chart study and a cross-sectional long-term follow-up of patients older than 4 years old, including all children with HD operated on with transanal endorectal pull-through (TERPT) at a tertiary center of pediatric surgery. Information about patient characteristics, diagnostics, surgery, and medical care was compiled. At long-term follow-up, bowel function was assessed by Bowel Function Score. Results. Included were 53 HD-patients, 13 with CHD and 40 without CHD. Children with CHD more commonly presented with failure to thrive; 4 (23%) compared to those without CHD (0%) (p < 0.01). In the long-term follow-up, including 32 patients (6 with CHD), constipation was more commonly reported by children with CHD 5 (83%) than by children without CHD 4 (27%) (p = 0.01). No differences were shown in the other parameters such as fecal control and incontinence. Conclusion. HD-patients with CHD more commonly presented with failure to thrive and more frequently reported constipation than HD-patients without CHD. The findings indicate that HD-patients with CHD might need special consideration in their initial care and long-term follow-up.

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“…Episodes of HAEC were diagnosed according to the HAEC score (HAEC score ≥ 4) and severity was graded from 1 to 3 according to published guidelines 3 , 8 . Diarrhoea was defined by more than 4 liquid stools per day (type A) after dietary diversification without OS 39 , 40 .…”

Section: Methodsmentioning

confidence: 99%

Analysis of enteric nervous system and intestinal epithelial barrier to predict complications in Hirschsprung’s disease

Dariel¹,

Grynberg²,

M³

et al. 2020

Sci Rep

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In Hirschsprung’s disease (HSCR), postoperative course remains unpredictable. Our aim was to define predictive factors of the main postoperative complications: obstructive symptoms (OS) and Hirschsprung-associated enterocolitis (HAEC). In this prospective multicentre cohort study, samples of resected bowel were collected at time of surgery in 18 neonates with short-segment HSCR in tertiary care hospitals. OS and HAEC were noted during postoperative follow-up. We assessed the enteric nervous system and the intestinal epithelial barrier (IEB) in ganglionic segments by combining immunohistochemical, proteomic and transcriptomic approaches, with functional ex vivo analysis of motility and para/transcellular permeability. Ten HSCR patients presented postoperative complications (median follow-up 23.5 months): 6 OS, 4 HAEC (2 with OS), 2 diarrhoea (without OS/HAEC). Immunohistochemical analysis showed a significant 41% and 60% decrease in median number of nNOS-IR myenteric neurons per ganglion in HSCR with OS as compared to HSCR with HAEC/diarrhoea (without OS) and HSCR without complications (p = 0.0095; p = 0.002, respectively). Paracellular and transcellular permeability was significantly increased in HSCR with HAEC as compared to HSCR with OS/diarrhoea without HAEC (p = 0.016; p = 0.009) and HSCR without complications (p = 0.029; p = 0.017). This pilot study supports the hypothesis that modulating neuronal phenotype and enhancing IEB permeability may treat or prevent postoperative complications in HSCR.

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Development of Frequency of Stools over Time in Children with Hirschsprung Disease Posttransanal Endorectal One-Stage Pull-through

Abstract: Background: The transanal endorectal one-stage pull-through (TERPT) procedure in

Cited by 5 publications

References 18 publications

Diagnosis, Symptoms, and Outcomes of Hirschsprung’s Disease from the Perspective of Gender

Diagnosis, Symptoms, and Outcomes of Hirschsprung’s Disease from the Perspective of Gender

Treatment and Patient Reported Outcome in Children with Hirschsprung Disease and Concomitant Congenital Heart Disease

Analysis of enteric nervous system and intestinal epithelial barrier to predict complications in Hirschsprung’s disease

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