Evaluation of Long Term Intestinal Functions In Children Who Underwent Transanal Endorectal Pull Through for Hirschsprung Disease

Abstract

Objective: The most preferred surgical method in the treatment of Hirschsprung’s disease (HD) recently is the transanal endorectal pull through (TERP) operation. In our study, we aim to evaluate the postoperative long- term follow up results of the patients. Method: The files of patients who had TERP between 2009 and 2019 in our center and were >3 years old after surgery were reviewed retrospectively. The patients were evaluated for bowel functions, continence and quality of life in outpatient clinic postoperatively. The information of patients who could not come to control was obtained by contacting their relatives over the phone. Parents were asked to fill Rintala intestinal functions questionnaire. Results: Forty-six patients were boys and 8 were girls. The mean age at diagnosis and surgery were 26.4 and 35.5 months respectively. The mean operation time was 140 minutes, and the mean aganglionic segment length was 21.5 cm. In the early postoperative period, anastomotic stricture was observed in 3 (5.5%), and enterocolitis in 2 (3.7%) patients. Constipation occured in 13 (24%) and soiling in 7 (13%) patients. Partial fecal incontinence was observed in 2 (3.7%) patients. Statistically significant difference was found between the height and weight percentile values of patients before and after surgery. The mean score was 19.05 in bowel function questionnaire. Conclusion: Our study showed that TERP can be applied with low complication rates. Patients have bowel movements and sphincter functions near to normal in the long term. With these advantages, TERP is an effective and reliable method for all HD age groups.