Long-term Functional Outcome And Quality Of Life After Operation For Hirschsprung’s Disease-transanal Endorectal Pull-through Vs Transabd-ominal Approach

Objective In order to choose the method of operation for Hirschsprung s disease (HD), this study examined the long-term functional outcome and quality of life of transanal endorectal pull-through (TERPT) versus transabdominal approach (TAA) for HD.Methods Records of90patients who underwent operation for HD(TERPT,n=50;TAA,n=40) between the years1998and2008were reviewed. Long-term outcome and quality of life were assessed by interviews and questionnaires including scoring systems.Results The TAA group experienced more late complications(33%vs29%with>2complications; P<.001). Overall scores were similar in two groups. However, continence score and the stool pattern score were significantly better in the TERPT group than TAA(p<.05). According to the Quality of Life Scoring Criteria,87.7%patients had good or fair quality of life.Comparison of quality of life showed no significant difference between the two groups(p>.05).There was a direct correlation between the quality of life and continence score(r=0.827,P<.001).Conclutions Our long-term study showed significantly better results regarding the continence score and the stool pattern for the TERPT compared withTAA. TERPT was associated with fewer complications and fewer episodes of enterocolitis. Comparison of quality of life showed no significant difference between the two groups. These results support the choose of TERP as a surgical approach for children with Hirschsprung’s disease.However, more cases will be needed to study before a definitive conclusion can be drawn.