Long-term growth outcomes in children with Hirschsprung disease after definitive surgery: A cross-sectional study

Gita Christy Gabriela; Esensi Tarian Geometri; Griselda Elisse Santoso; Kemala Athollah; Aditya Rifqi Fauzi; Janatin Hastuti; Gunadi

doi:10.1016/j.amsu.2020.09.038

Long-term growth outcomes in children with Hirschsprung disease after definitive surgery: A cross-sectional study

Ann Med Surg (Lond). 2020 Oct 2:59:176-179. doi: 10.1016/j.amsu.2020.09.038. eCollection 2020 Nov.

Authors

Gita Christy Gabriela¹, Esensi Tarian Geometri¹, Griselda Elisse Santoso¹, Kemala Athollah¹, Aditya Rifqi Fauzi¹, Janatin Hastuti², Gunadi¹

Affiliations

¹ Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
² Laboratory of Bioanthropology and Paleoanthropology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia.

Abstract

Background: The growth of children with Hirschsprung disease (HSCR) can be affected by many factors, including the environment, nutrient intake, and surgery. Our study compared the long-term (i.e., at least 3 years of follow-up) growth outcomes in HSCR children after transabdominal Soave and Duhamel and transanal endorectal pull-through (TEPT) surgeries.

Methods: A cross-sectional study was conducted in children <18 years of age diagnosed histopathologically with HSCR who underwent pull-through between January 1, 2012-December 31, 2015 in our institution. The postoperative anthropometric data were obtained prospectively through interviews during the outpatient clinic appointment or by telephone.

Results: We recruited 21 patients (Soave: 7 vs. Duhamel: 4 vs. TEPT: 10; p = 0.06). There were no significant differences between the three surgical methods in terms of preoperative and postoperative nutritional status categories (p = 0.52). Concerning the changes in nutritional status, after Soave surgery, it was improved, steady, and worsened in 28.6%, 57.1%, and 14.3% of the children, respectively. The nutritional status of the Duhamel group was worsened and steady in 25% and 75% of the children, respectively, while in the TEPT group, it was improved and steady in 40% and 60% of the children, respectively. However, these differences were not statistically significant (p = 0.42).

Conclusions: While some HSCR children show an improvement in their nutritional status after Soave and TEPT procedures, the overall nutritional status is similar among different procedures. Further multicenter studies with a larger sample size are important to clarify our findings.

Keywords: BAZ, body mass index-for-age z-score; HAEC, Hirschsprung-associated enterocolitis; HSCR, Hirschsprung disease; Hirschsprung disease; ICD10, The International Statistical Classification of Diseases and Related Health Problems, 10th Revision; IQR, interquartile range; Long-term growth outcomes; Nutritional status; TEPT, transanal endorectal pull-through; Transabdominal soave and duhamel surgeries; Transanal endorectal pull-through; WAZ, weight-for-age z-score; WHO, World Health Organization.