title: Comparative review of functional outcomes post surgery for Hirschsprung's disease utilizing the paediatric incontinence and constipation scoring system.
abstract: OBJECTIVE
  We aim to analyze differences in functional outcomes in children operated on for Hirschsprung's disease (HD) using the Paediatric incontinence/constipation scoring system (PICSS) validated in a normative group.
  
  
  METHODS
  A retrospective review of the records of all children operated on for HD between 1997 and 2010 was performed. Patients had either a Soave or transanal endorectal pull-through. Children with total colonic aganglionosis and Down's syndrome were excluded. Utilizing the PICSS children who scored below their age-specific lower limit 95 % confidence interval PICSS scores were considered to have incomplete continence or constipation. The rates of incomplete continence and constipation were compared between groups. Significance was set at p < 0.05.
  
  
  RESULTS
  PICSS analysis could be completed in 51 (Soave 35, transanal 16). The median age at interview was 71 months (range 6-191 months). The rate of incomplete continence was 75 % (n = 21) and 71 % (n = 10) for the Soave and transanal groups, respectively (p = 1.00). The constipation rate was 34 % (n = 12) and 25 % (n = 4) for the Soave and transanal groups, respectively (p = 0.74). The overall rates of incomplete continence and constipation rates were 74 and 31 %, respectively, compared with 14 and 10 %, respectively, when rates were calculated by review of records.
  
  
  CONCLUSIONS
  The PICSS is a sensitive tool for assessing functional outcome post HD surgery. The Soave and transanal procedures have similar functional outcomes.
authors.affiliation: Department of Paediatric Surgery, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland. drgbenga@hotmail.com
authors.forename: Olugbenga Michael
authors.initials: OM
authors.lastname: Aworanti
authors.forename: Dermot Thomas
authors.initials: DT
authors.lastname: Mcdowell
authors.forename: Ian Michael
authors.initials: IM
authors.lastname: Martin
authors.forename: Judy
authors.initials: J
authors.lastname: Hung
authors.forename: Feargal
authors.initials: F
authors.lastname: Quinn
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000453:epidemiology / Q000209:etiology; D005242:Fecal Incontinence / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006627:Hirschsprung Disease / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome