Results of Management for Hirschsprung’s Disease in Maharat Nakhon Ratchasima Hospital

Abstract

Background: Short-term and long-term results of surgical treatment for Hirschsprung’s disease differ significantly from patient to patient and are unpredictable. Postoperative and late complications occur in many cases. There are no clues when normal defecation to occur. Factors related to complications should be studied in order to improve treatment outcomes. Objective: To present results of management for Hirschsprung’s disease in Maharat Nakhon Ratchasima Hospital and to propose factors that may contribute to complications and results of treatment. Method: Hirschsprung’s disease patients who had been admitted in Maharat Nakhon Ratchasima Hospital during January 1986 and December 2000 were retrospectively reviewed. Information collected included signs and symptoms, history of diagnosis and preoperative diversion, age at time of operation, length of aganglionic segment, surgical technique, post operative complication, follow up period, defection pattern and final status. The information was collected by reviewing the hospital records and was analyzed using descriptive statistics, frequency distribution, percentage and chi-square analysis. A p value of 0.05 was considered statistically significant. Results: There were 193 patients, 160 boys and 33 girls. The patients’ age at the time of resection ranged from 4 months to 10 years. The longest follow up period was 10 years. Postoperative mortality rate was 3.1%. The most common complication was achalasia while early complications were enterocolitis, retracted anastomosis and anastomotic leakage. Factors that might influence the results of management included delayed diagnosis, operative technique and age at time of resection. Most patients had normal defecation within two years. Late complications were possible, so that at least two years follow-up should be done in all cases. Conclusion: Reviewing results of treatment and comparing these results with those obtained from other institutes should lead to better management for Hirschsprung’s disease so that to reduce risk of complications and put the patient to normal defecation as soon as possible.