Investigations for incontinence and constipation after surgery for Hirschsprung's disease in children

Keshtgar, Alireza S.; Ward, Harry C.; Clayden, Graham; Sousa, N M de

doi:10.1007/s00383-002-0897-x

Cited by 64 publications

(40 citation statements)

References 15 publications

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“…All patients to a greater or lesser extent showed significant progression of the intestinal bolus after PTAI and a mixing of the intestinal markers. These results could be attributed not only to the mechanical action of irrigation but also to stimulation of colon peristalsis [5,6].…”

Section: Discussionmentioning

confidence: 96%

Peristeen^® transanal irrigation in paediatric patients with anorectal malformations and spinal cord lesions: a multicentre Italian study

et al. 2016

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Section: Discussionmentioning

confidence: 96%

Peristeen^® transanal irrigation in paediatric patients with anorectal malformations and spinal cord lesions: a multicentre Italian study

et al. 2016

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“…Similar findings have been identified in other studies. 6,27 Sphincter function appears to be important to continence but the mechanism is uncertain. Three of the 16 who had manometry had developed a normal recto-anal inhibitory reflex, but this was not associated with the establishment of continence.…”

Section: Discussionmentioning

confidence: 99%

“…5 More recent studies have confirmed that fecal incontinence is an issue that merits further study. [5][6][7][8] The purpose of the current study was to broaden our previous investigations 4 of long-term continence, to evaluate a wider aspect of bowel function and to assess associated health and social issues.…”

Section: Introductionmentioning

confidence: 99%

Long‐term continence after surgery for Hirschsprung's disease

Catto‐Smith

Trajanovska

Taylor

2007

J of Gastro and Hepatol

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“…Several studies have reported better postoperative bowel function after TEPT operation. [4][5][6][14][15][16] Lastly, the potential injury to the pelvic nerve or genitourinary nerves during Duhamel or Swenson operation is avoided by leaving the aganglionic muscular layer in the rectum untouched.…”

Section: Discussionmentioning

confidence: 99%

“…A few reports have demonstrated its role for postoperative assessment after surgery for Hirschsprung's disease. 6,7 However, its application for post-TEPT operation assessment has not yet been established. For this purpose, we conducted a study to validate the use of anorectal manometry as a standard tool for assessment after TEPT operation.…”

Section: Introductionmentioning

confidence: 99%

Clinical and manometric evaluations of anorectal function in patients after transanal endorectal pull‐through operation for Hirschsprung's disease: A multicentre study

et al. 2015

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Aim: Transanal endorectal pull-through (TEPT) operation is one the most popular operations for Hirschsprung's disease. This aim of the present study was to evaluate its outcome by clinical and manometric assessments. Patients and Methods: This study was a multicentred study involving all three paediatric surgical centres under the Hospital Authority in Hong Kong. All patients, over the age of 3 years, who had undergone primary TEPT operation for more than 1 year, were included in the present study. Clinical evaluation with bowel function score (BFS) and anorectomanometry were carried out. A BFS > 18 and sphincter resting pressure between 30 mmHg and 60 mmHg were considered normal. Those with concomitant anorectal/neurological anomaly or who could not cooperate were excluded. Results: A total of 37 patients were enrolled in this study. The median age was 60 months (range: 36-144 months), and the median age at the time of operation was 3 months (range: 0.5-60 months).With respect to functional outcomes, six patients (16.2 per cent) suffered from constipation, but more than two-thirds of patients had satisfactory stool consistency, as well as frequency. Sixteen patients (43.2 per cent) had no report of any soiling. For the BFS, 26 patients had a BFS above 18, with the median value being 16 (range: 7-20). Manometric assessment revealed that 27 patients (72.9 per cent) had sphincteric resting pressure within the normal value, and the median value was 45 mmHg (range: 14-79 mmHg). Rectoanal inhibitory reflex was present in six patients (16.2 per cent), and the median value for the volume of air to elicit the first anal sensation was 41 mL (range: 18-126 mL). Using univariate analysis, long segment disease was identified as a risk factor for developing soiling of more than two times per week [relative risk (RR): 1.87, 95 per cent confidence interval (CI):1.03-2.22, P = 0.05], whereas the creation of stoma (RR: 1.69, 95 per cent CI: 1.41-2.14, P = 0.04) and occurrence of postoperative enterocolitis (RR: 1.58, 95 per cent CI: 1.36-1.0, P = 0.04) were risk factors for abnormal bowel function score. There was no significant risk factor identified for abnormal manometric results. Lastly, patients with abnormal sphincter resting pressure detected in the anorectomanometry study were also more likely to have an abnormal BFS. Conclusion: Most patients have satisfactory clinical and manometric outcomes after primary TEPT operation. Anorectomanometry findings can predict clinical outcomes. Patients with long segment disease, development of enterocolitis and stoma creation before operation will need more attention, as they are prone to develop abnormal bowel function. Early interventions, such as manometric assessment and proper bowel management, are recommended in order to correct bowel dysfunction, as well enabling patients to have a better quality of life.

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Investigations for incontinence and constipation after surgery for Hirschsprung's disease in children

Cited by 64 publications

References 15 publications

Peristeen^® transanal irrigation in paediatric patients with anorectal malformations and spinal cord lesions: a multicentre Italian study

Peristeen^® transanal irrigation in paediatric patients with anorectal malformations and spinal cord lesions: a multicentre Italian study

Long‐term continence after surgery for Hirschsprung's disease

Clinical and manometric evaluations of anorectal function in patients after transanal endorectal pull‐through operation for Hirschsprung's disease: A multicentre study

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Investigations for incontinence and constipation after surgery for Hirschsprung's disease in children

Cited by 64 publications

References 15 publications

Peristeen® transanal irrigation in paediatric patients with anorectal malformations and spinal cord lesions: a multicentre Italian study

Peristeen® transanal irrigation in paediatric patients with anorectal malformations and spinal cord lesions: a multicentre Italian study

Long‐term continence after surgery for Hirschsprung's disease

Clinical and manometric evaluations of anorectal function in patients after transanal endorectal pull‐through operation for Hirschsprung's disease: A multicentre study

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Peristeen^® transanal irrigation in paediatric patients with anorectal malformations and spinal cord lesions: a multicentre Italian study

Peristeen^® transanal irrigation in paediatric patients with anorectal malformations and spinal cord lesions: a multicentre Italian study