Long-term stooling patterns in infants undergoing primary endorectal pull-through for Hirschsprung's disease.
Primary endorectal pull-through (ERPT) has become an increasingly popular method of caring for neonates and young infants who have Hirschsprung's disease. This study evaluated the long-term stooling patterns and continence rates of patients who had a primary ERPT as a young infant. The records of 24 infants who underwent a primary ERPT for Hirschsprung's disease were reviewed. The patients' families (those patients over 3 years of age, n = 12) underwent a detailed interview that graded continence from 0 (poor) to 10 (normal). Mean age at ERPT was 15 +/- 17 days (range, 2 to 67). Mean follow-up was 1,036 +/- 614 days. Nine patients suffered from 20 episodes of enterocolitis. Stooling frequency declined rapidly in the first 6 months after the ERPT (r2 = 1.00) and more slowly after this time (r2 = 0.79). Continence was graded as normal (10) in one, good (6 to 9 points) in nine, and fair (1 to 5) in two patients, both of whom had total colonic disease. The authors conclude that a primary ERPT in the young infant who has Hirschsprung's disease can yield excellent results including normalization of stooling frequency and good to excellent levels of continence.
Teitelbaum
D H
DH
University of Michigan Medical Center and the C.S. Mott Children's Hospital, Ann Arbor 48109, USA.
Drongowski
R A
RA
Chamberlain
J N
JN
Coran
A G
AG
D003248:Constipation / Q000209:etiology; D003672:Defecation / Q000502:physiology*; D004760:Enterocolitis / Q000209:etiology; D005242:Fecal Incontinence / Q000209:etiology; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011183:Postoperative Complications; D011184:Postoperative Period; D012007:Rectum / Q000601:surgery*