Perioperative and Long-Term Functional Outcomes of Children With Early Diagnosis Versus Late Diagnosis of Hirschsprung's Disease: A 30-Year Monocentric Retrospective Study.

PURPOSE: The purpose of this study was to compare the perioperative course and long-term functional outcomes of children with early and late diagnosis of Hirschsprung's disease (HD).

METHODS

This retrospective study included patients affected by HD who underwent pull-through between 1984 and 2015. Patients were classified into two groups: early diagnosis of HD (EDHD) before 1 year of age and late diagnosis of HD (LDHD) after 1 year. Functional outcomes at 3, 6, and 9 years after surgery were analyzed.

RESULTS

One hundred and five patients, 83.8% with EDHD and 16.2% with LDHD. Abdominal distension and vomiting were the main presenting symptoms of EDHD, whereas chronic constipation was the primary symptom of LDHD. Preoperative intestinal obstruction occurred in 59.1% of EDHD versus 5.9% of LDHD (p < 0.0001). Diverting colostomy was performed in 31.8% of EDHD versus 5.9% in LDHD (p = 0.03). Anal strictures needing anal dilatation occurred in 30.7% of EDHD versus 5.9% in LDHD (p = 0.03). At 3 years of follow-up, there was a statistical difference in terms of constipation (10% in EDHD vs. 23.5% in LDHD; p = 0.04), but not in terms of soiling (30.7% vs. 29.4%; p = 0.65); 9 years after surgery, comparable results were shown in terms of both constipation and soiling.

CONCLUSION

Long-term functional outcome is generally comparable between patients with EDHD and LDHD.