title: [Long-term results and quality of life in patients after surgery in childhood for Hirschsprung's disease by the Kasai method of colo(ileo)rectoplasty].
abstract: BACKGROUND
  Evaluation of faecal continence, education and occupation of patients operated during childhood on account of Hirschsprung's disease by Kasai's colo(ileo)rectoplasty.
  
  
  METHODS
  Analysis of data from questionnaire, ambulatory check-up examinations and case-records of 46 patients of 109 operated in 1979-1995.
  
  
  RESULTS
  Of 46 patients (36 men, 10 women) aged 18 to 35 years (mean age 22.5 years) 42 patients (33 M, 9 F) had the classical or long type of HD, 4 patients (3 M, 1 F) suffered from aganglionosis of the entire colon (TCA). The follow-up period after operation was 8 to 24 years (on average 13.5 years) 23 patients (50%) were quite free from complaints, 23 patients (50%) have occasional complaints: constipation 8 (14.4%), diarrhoea 5 (10.9%), soiling 20 (43.5%), abdominal pain 16 (34.8%). One patient has pain in the rectum, one female patient painful sexual intercourse, 4 (8.7%) suffer from meteorism. 6(13%) patients use laxatives, 8 (17.4%) enemas. Four (8.7%) patients were reoperated on account of residual aganglionosis. Seven (15.2%) patients had a partial sphincteromyectomy of the internal anal sphincter. Two patients had ileus with adhesion, one patient resection of a urethral stricture, one female patient with TCA total thyroidectomy on account of a medullary thyroid carcinoma. Eight (16.3%) patients have elementary education, 14 (30.4%) completed an apprenticeship, 22 (47.8%) have secondary education, 2 (4.3%) have university education. Forty four (95.6%) patients work full time.
  
  
  CONCLUSIONS
  Although occasional soiling is reported by 43.5% patients, all patients evaluate their situation as good or adequate.
authors.affiliation: Klinika dĕtské chirurgie UK 2. LF a FN Motol, subkatedra dĕtské chirurgie IPVZ, Praha. richard.skaba@lfmotol.cuni.cz
authors.forename: R
authors.initials: R
authors.lastname: Skába
authors.forename: M
authors.initials: M
authors.lastname: Simsová
mesh_terms: D000293:Adolescent; D000328:Adult; D003106:Colon / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D011183:Postoperative Complications; D011788:Quality of Life; D012007:Rectum / Q000601:surgery*; D011795:Surveys and Questionnaires