Published in:
Open Access 01-12-2018 | Research article
Functional outcomes in Hirschsprung disease patients after transabdominal Soave and Duhamel procedures
Published in: BMC Gastroenterology | Issue 1/2018
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Background
Several pull-through procedures have been described for Hirschsprung
disease (HSCR) with varying functional outcomes. The voluntary bowel movement
(VBM) and the absence of soiling or constipation after pull-through remain the
most important markers of good outcome. We aimed to compare the functional
outcomes in HSCR patients following Soave and Duhamel procedures.
Methods
Krickenbeck classification was utilized to determine VBM, soiling
and constipation for patients who underwent Soave and Duhamel pull-through at Dr.
Sardjito Hospital, Indonesia from 2013 to 2016.
Results
Fifty-three patients were ascertained (Soave: 23 males and 2 females
vs. Duhamel: 22 males and 6 females, p = 0.26).
Ninety-three and 88% patients had a VBM following Duhamel and Soave pull-through,
respectively (p = 0.66). Constipation frequency
was significantly higher in Soave than Duhamel groups (24% vs. 4%; p = 0.04) with OR of 8.5 (95% CI = 1.0–76.7), whereas
soiling rate was similar between Duhamel (21%) and Soave (8%) groups (p = 0.26). Furthermore, the risk of constipation was
increased ~ 21.7-fold in female patients after Soave procedure and was almost
statistically significant (p = 0.05).
Conclusions
The constipation rate is higher in patients who underwent Soave than
Duhamel procedure, but the VBM and soiling frequencies are similar. The
constipation risk following Soave pull-through might be increased by the female
gender. Furthermore, a multicenter study with a larger sample of patients is
necessary to clarify and confirm our findings.