A Nordic multicenter survey of long-term bowel function after transanal endorectal pull-through in 200 patients with rectosigmoid Hirschsprung disease

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A Nordic multicenter survey of long-term bowel function after transanal endorectal pull-through in 200 patients with rectosigmoid Hirschsprung disease. / Bjørnland, Kristin; Pakarinen, Mikko P; Stenstrøm, Pernilla; Stensrud, Kjetil J; Neuvonen, Malla; Granström, Anna L; Graneli, Christina; Pripp, Are H; Arnbjörnsson, Einar; Emblem, Ragnhild; Wester, Tomas; Rintala, Risto J; Nordic Pediatric Surgery Study Consortium.

I: Journal of Pediatric Surgery, Vol. 52, Nr. 9, 2017, s. 1458-1464.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Harvard

Bjørnland, K, Pakarinen, MP, Stenstrøm, P, Stensrud, KJ, Neuvonen, M, Granström, AL, Graneli, C, Pripp, AH, Arnbjörnsson, E, Emblem, R, Wester, T, Rintala, RJ & Nordic Pediatric Surgery Study Consortium 2017, 'A Nordic multicenter survey of long-term bowel function after transanal endorectal pull-through in 200 patients with rectosigmoid Hirschsprung disease', Journal of Pediatric Surgery, vol. 52, nr. 9, s. 1458-1464. https://doi.org/10.1016/j.jpedsurg.2017.01.001

APA

Bjørnland, K., Pakarinen, M. P., Stenstrøm, P., Stensrud, K. J., Neuvonen, M., Granström, A. L., Graneli, C., Pripp, A. H., Arnbjörnsson, E., Emblem, R., Wester, T., Rintala, R. J., & Nordic Pediatric Surgery Study Consortium (2017). A Nordic multicenter survey of long-term bowel function after transanal endorectal pull-through in 200 patients with rectosigmoid Hirschsprung disease. Journal of Pediatric Surgery, 52(9), 1458-1464. https://doi.org/10.1016/j.jpedsurg.2017.01.001

CBE

Bjørnland K, Pakarinen MP, Stenstrøm P, Stensrud KJ, Neuvonen M, Granström AL, Graneli C, Pripp AH, Arnbjörnsson E, Emblem R, Wester T, Rintala RJ, Nordic Pediatric Surgery Study Consortium. 2017. A Nordic multicenter survey of long-term bowel function after transanal endorectal pull-through in 200 patients with rectosigmoid Hirschsprung disease. Journal of Pediatric Surgery. 52(9):1458-1464. https://doi.org/10.1016/j.jpedsurg.2017.01.001

MLA

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Author

Bjørnland, Kristin ; Pakarinen, Mikko P ; Stenstrøm, Pernilla ; Stensrud, Kjetil J ; Neuvonen, Malla ; Granström, Anna L ; Graneli, Christina ; Pripp, Are H ; Arnbjörnsson, Einar ; Emblem, Ragnhild ; Wester, Tomas ; Rintala, Risto J ; Nordic Pediatric Surgery Study Consortium. / A Nordic multicenter survey of long-term bowel function after transanal endorectal pull-through in 200 patients with rectosigmoid Hirschsprung disease. I: Journal of Pediatric Surgery. 2017 ; Vol. 52, Nr. 9. s. 1458-1464.

RIS

TY - JOUR

T1 - A Nordic multicenter survey of long-term bowel function after transanal endorectal pull-through in 200 patients with rectosigmoid Hirschsprung disease

AU - Bjørnland, Kristin

AU - Pakarinen, Mikko P

AU - Stenstrøm, Pernilla

AU - Stensrud, Kjetil J

AU - Neuvonen, Malla

AU - Granström, Anna L

AU - Graneli, Christina

AU - Pripp, Are H

AU - Arnbjörnsson, Einar

AU - Emblem, Ragnhild

AU - Wester, Tomas

AU - Rintala, Risto J

AU - Nordic Pediatric Surgery Study Consortium

N1 - Copyright © 2017 Elsevier Inc. All rights reserved.

PY - 2017

Y1 - 2017

N2 - OBJECTIVE: Transanal endorectal pull-through (ERPT) is the most popular technique to treat Hirschsprung disease (HD). Still, there is limited knowledge on long-term bowel function. This cross-sectional, multicenter study assessed long-term bowel function in a large HD population and examined predictors of poor outcome.METHODS: Patients older than four years or their parents filled out a validated questionnaire on bowel function. Clinical details were recorded retrospectively from medical records.RESULTS: 73/200 (37%) patients reported absolutely no impaired bowel function, meaning no constipation, fecal accidents, stoma, appendicostomy or need for enemas. Seven (4%) had a stoma, and 33 (17%) used antegrade or rectal colonic enemas. Most disarrangements of fecal control and constipation were significantly less common in older age group, but abnormal defecation frequency and social problems remained unchanged. Syndromic patients (n=31) experienced frequent fecal accidents (46%) more often than nonsyndromic (14%, P<0.001). Having a syndrome (adjusted OR 5.6, 95% CI 2.1-15, P=0.001) or a complete transanal ERPT (adjusted OR 2.4, 95% CI 1.1-5.7, P=0.038) was significantly associated with poor outcome defined as having a stoma, an appendicostomy, daily fecal accidents or need of regular rectal wash outs.CONCLUSION: A significant number of HD patients experience bowel problems many years after definite surgery. Fecal control was significantly better in older than younger HD patients, but some continued to have considerable bowel problems also as adults. A total transanal ERPT was associated with poorer outcome. Long-term follow-up of HD patients is warranted. Prognosis Study: Level II.

AB - OBJECTIVE: Transanal endorectal pull-through (ERPT) is the most popular technique to treat Hirschsprung disease (HD). Still, there is limited knowledge on long-term bowel function. This cross-sectional, multicenter study assessed long-term bowel function in a large HD population and examined predictors of poor outcome.METHODS: Patients older than four years or their parents filled out a validated questionnaire on bowel function. Clinical details were recorded retrospectively from medical records.RESULTS: 73/200 (37%) patients reported absolutely no impaired bowel function, meaning no constipation, fecal accidents, stoma, appendicostomy or need for enemas. Seven (4%) had a stoma, and 33 (17%) used antegrade or rectal colonic enemas. Most disarrangements of fecal control and constipation were significantly less common in older age group, but abnormal defecation frequency and social problems remained unchanged. Syndromic patients (n=31) experienced frequent fecal accidents (46%) more often than nonsyndromic (14%, P<0.001). Having a syndrome (adjusted OR 5.6, 95% CI 2.1-15, P=0.001) or a complete transanal ERPT (adjusted OR 2.4, 95% CI 1.1-5.7, P=0.038) was significantly associated with poor outcome defined as having a stoma, an appendicostomy, daily fecal accidents or need of regular rectal wash outs.CONCLUSION: A significant number of HD patients experience bowel problems many years after definite surgery. Fecal control was significantly better in older than younger HD patients, but some continued to have considerable bowel problems also as adults. A total transanal ERPT was associated with poorer outcome. Long-term follow-up of HD patients is warranted. Prognosis Study: Level II.

U2 - 10.1016/j.jpedsurg.2017.01.001

DO - 10.1016/j.jpedsurg.2017.01.001

M3 - Article

C2 - 28094015

VL - 52

SP - 1458

EP - 1464

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 1531-5037

IS - 9

ER -