[Long-term results and quality of life in patients after surgery in childhood for Hirschsprung's disease by the Kasai method of colo(ileo)rectoplasty].

BACKGROUND

Evaluation of faecal continence, education and occupation of patients operated during childhood on account of Hirschsprung's disease by Kasai's colo(ileo)rectoplasty.

MATERIAL AND

METHODS

Analysis of data from questionnaire, ambulatory check-up examinations and case-records of 46 patients of 109 operated in 1979-1995.

RESULTS

Of 46 patients (36 men, 10 women) aged 18 to 35 years (mean age 22.5 years) 42 patients (33 M, 9 F) had the classical or long type of HD, 4 patients (3 M, 1 F) suffered from aganglionosis of the entire colon (TCA). The follow-up period after operation was 8 to 24 years (on average 13.5 years) 23 patients (50%) were quite free from complaints, 23 patients (50%) have occasional complaints: constipation 8 (14.4%), diarrhoea 5 (10.9%), soiling 20 (43.5%), abdominal pain 16 (34.8%). One patient has pain in the rectum, one female patient painful sexual intercourse, 4 (8.7%) suffer from meteorism. 6(13%) patients use laxatives, 8 (17.4%) enemas. Four (8.7%) patients were reoperated on account of residual aganglionosis. Seven (15.2%) patients had a partial sphincteromyectomy of the internal anal sphincter. Two patients had ileus with adhesion, one patient resection of a urethral stricture, one female patient with TCA total thyroidectomy on account of a medullary thyroid carcinoma. Eight (16.3%) patients have elementary education, 14 (30.4%) completed an apprenticeship, 22 (47.8%) have secondary education, 2 (4.3%) have university education. Forty four (95.6%) patients work full time.

CONCLUSION

Although occasional soiling is reported by 43.5% patients, all patients evaluate their situation as good or adequate.