Long-term Results and Quality of Life of Patients Operated in Childhood for Hirschsprung's Disease by Kasai's Colo(ileo) Rectoplasty
Abstract
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 oi 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, 1F) suffered from aganghonosis 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 aganghonosis.
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 secondai 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.