Patient-reported Swedish nationwide outcomes of children and adolescents with total colonic aganglionosis

Research output: Contribution to journalArticle

Abstract

Background: The aim of this study was to evaluate the nationwide outcome of children with total colonic aganglionosis (TCA) during the last 20. years. Methods: This was an observational, cross-sectional study where all patients with TCA, including aganglionosis of 0-50. cm of ileum, born in Sweden 1995-2014 were included. Data were collected from the medical records. Patients>. 4. years old without stoma answered a questionnaire regarding bowel function (bowel function score, BFS, score 1-20), medical treatment and nutrition. Results: Twenty-seven children were included. Twenty-five children were reconstructed at median age of 56 (4-236) weeks. Reconstruction procedures included Swenson (6), Soave (5), mucosectomy with short muscular cuff with or without J-pouch (9), Duhamel (3) and Rehbein (2). There was no mortality. The median follow-up time was 9.5. years (8. months-20. years). At follow-up 7 (26%) patients had an ileostomy, 4 with a syndrome. Eight patients required parenteral support, until a median age of 11 (2-24) months. Oral energy support was used by 5/27 (15%), still 5/22 (23%) were underweighted. Obstructive symptoms were reported by 7/20 (31%). All 17 patients>. 4. years old completed the BFS questionnaire at median age of 10 (4-20) years. Median stool frequency/24. h was 5 (1-30). Fecal accidents at least once per week was reported by 4 (24%), and social problems by 8 (47%). The median BFS was 15 (11-19) without any gender differences. Conclusion: One-third of patients with TCA report obstructive symptoms, one-third need additional nutrition and one-fifth require a permanent stoma. TCA have a negative impact on social life. Subsequently, children with TCA need a careful lifelong follow-up of specialized teams.

Details

Authors
Organisations
External organisations
  • Skåne University Hospital
  • Sahlgrenska Academy
  • Karolinska University Hospital
  • Uppsala University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Pediatrics
  • Gastroenterology and Hepatology

Keywords

  • Bowel function, Hirschsprung disease, Nutrition, Total colonic aganglionosis
Original languageEnglish
Pages (from-to)1302-1307
JournalJournal of Pediatric Surgery
Volume52
Issue number8
Early online date2016 Nov 17
Publication statusPublished - 2017
Publication categoryResearch
Peer-reviewedYes