Journal of Indian Association of Pediatric Surgeons · 2026
Profile of Quality of Life in Children with Extrahepatic Portal Vein Obstruction: A Cross-sectional Comparative Study.
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Tomar Shreya, Kumar Bitesh, Bajpai Minu, Agarwala Sandeep, Satapathy Sujata, Malik Rohan, Bhatnagar Veereshwar, Jain Vishesh, Yadav Devendra Kumar, Goel Prabudh, Dhua Anjan Kumar
Аннотация
BACKGROUND: Extrahepatic portal venous obstruction (EHPVO) is a chronic condition in children associated with recurrent gastrointestinal bleeding, hypersplenism, and growth impairment. While surgical and endoscopic interventions address portal hypertension, their impact on Health-related Quality of Life (HRQoL) remains incompletely understood.
MATERIALS AND METHODS: This cross-sectional comparative study evaluated HRQoL using the Pediatric Quality of Life Inventory (PedsQL™ 4.0) in children with EHPVO undergoing endoscopic management (preshunt group), those who had undergone surgical intervention (postshunt group), and age-matched healthy sibling controls. Both child self-reports and parent proxy-reports were analyzed. Nonparametric statistical methods were used, and effect sizes were calculated to assess clinical relevance.
RESULTS: Children with EHPVO demonstrated significantly lower overall HRQoL compared with healthy controls across all domains (P < 0.001), with large effect sizes (r ≈ 0.8), indicating clinically meaningful impairment. No statistically significant difference was observed between pre- and postshunt groups, with small effect sizes suggesting minimal variation at the time of assessment. Median follow-up duration in the postoperative cohort exceeded 1 year across all surgical subgroups. Domain-wise analysis revealed the greatest impairment in school functioning, followed by physical and emotional domains. Strong concordance was observed between child self-reports and parent proxy-reports.
CONCLUSION: Children with EHPVO experience substantial impairment in HRQoL compared with healthy peers. While no significant differences were observed between treatment groups, HRQoL remains suboptimal within the follow-up period captured in this cross-sectional study. These findings highlight the need for comprehensive, multidisciplinary care addressing psychosocial, educational, and nutritional aspects alongside standard medical and surgical management.
MATERIALS AND METHODS: This cross-sectional comparative study evaluated HRQoL using the Pediatric Quality of Life Inventory (PedsQL™ 4.0) in children with EHPVO undergoing endoscopic management (preshunt group), those who had undergone surgical intervention (postshunt group), and age-matched healthy sibling controls. Both child self-reports and parent proxy-reports were analyzed. Nonparametric statistical methods were used, and effect sizes were calculated to assess clinical relevance.
RESULTS: Children with EHPVO demonstrated significantly lower overall HRQoL compared with healthy controls across all domains (P < 0.001), with large effect sizes (r ≈ 0.8), indicating clinically meaningful impairment. No statistically significant difference was observed between pre- and postshunt groups, with small effect sizes suggesting minimal variation at the time of assessment. Median follow-up duration in the postoperative cohort exceeded 1 year across all surgical subgroups. Domain-wise analysis revealed the greatest impairment in school functioning, followed by physical and emotional domains. Strong concordance was observed between child self-reports and parent proxy-reports.
CONCLUSION: Children with EHPVO experience substantial impairment in HRQoL compared with healthy peers. While no significant differences were observed between treatment groups, HRQoL remains suboptimal within the follow-up period captured in this cross-sectional study. These findings highlight the need for comprehensive, multidisciplinary care addressing psychosocial, educational, and nutritional aspects alongside standard medical and surgical management.