Prognostic factors for persistent obstructive symptoms in patients with Hirschsprung disease following pull-through

Naisya Balela, Aditya Rifqi Fauzi, Ninditya Nugroho, Andi Dwihantoro and Gunadi

PLOS ONE, 2023, vol. 18, issue 9, 1-9

Abstract: Background: Although most patients with Hirschsprung disease (HSCR) improve after pull-through, some patients still have persistent obstructive symptoms. Most previous studies reported persistent obstructive symptoms after pull-through in HSCR patients from developed countries. Our study determined the prognostic factors of persistent obstructive symptoms in patients with HSCR following pull-through from a particular developing country. Methods: A cross-sectional study was conducted using medical records of patients with HSCR at our institution from January 2017 to January 2022. Results: We ascertained 114 patients with HSCR: 79 males and 35 females. Most of them (90.4%) showed a short aganglionosis and underwent transanal endorectal pull-through (55.3%). Twenty-two percent of patients showed persistent obstructive symptoms following pull-through. Operative technique and age at definitive surgery were significantly associated with the persistent obstructive symptoms after pull-through (p = 0.011 and 0.019, respectively), while sex, aganglionic segment length, presence of global developmental delay, and Down syndrome were not (p = 0.873, 0.525, 0.647, and 0.301, respectively). Multivariate analysis revealed that age at pull-through was a significant independent factor for persistent obstructive symptoms after pull-through, with an odds ratio of 3.41 (95% CI = 1.18–9.91; p = 0.02). Conclusions: Our study shows a moderate frequency of persistent obstructive symptoms after pull-through in our institution. In addition, patients who underwent pull-throughs at a younger age might have persistent obstructive symptoms following a definitive surgery. Our study provides new data on persistent obstructive symptoms after pull-through from a particular population that might be beneficial for pediatric surgeons’ consideration before performing definitive surgery on patients with HSCR.

Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0290430

DOI: 10.1371/journal.pone.0290430

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