Long-term follow-up of bowel function, behaviors and psychological situations of the children underwent operations for Hirschsprung's disease

Objective To study the bowel function, behaviors and psychological situations of the children underwent heart-shaped anastomosis operation for Hirschsprung's disease. Methods Between January 2001 and January 2011, 218 HD children underwent heart-shaped anastomosis operations at this center. The patients were followed up by telephone, mail and hospital referrals. According to the follow-up term, the 218 patients were divided into 3 groups:1 year group, 1-5 years group and 5-10 years group. Soiling, incontinence, constipation reoccurrence, enterocolitis, severe retention of urine was recorded. Barium enema and anorectal manometry was also followed up. Behaviors and psychological situations was quantified using child behavior checklist (CBCL). Results There was no recurrence of constipation in 1 year group. However, the Keding score of 1 year group was lower and incidence of soiling was higher than that in the other 2 groups. No fecal incontinence and intractable urinary retention was noted. The anal resting pressure, high-pressure zone length and initiative systolic pressure of HD children in 1 year group were lower than those in the other 2 groups. Barium enema showed that the lengths of anal canal of 1 year group were significant shorter than that in the other 2 groups. However, barium retention and overflow were more severe than the other 2 groups. Barium enema revealed the colon was still and did not formed typical anorectal angle in 8 HD patients of 1 year group. Psychological and behavioral problems of these HD children were physical complaints, social withdrawal, hyperactivity and discipline break. Conclusions Heart-Shaped anastomosis operation is safe and effective to treat HD. Key words: Hirschsprung's disease;  Anastomosis, surgical;  Follow-up studies