Early and long-term results of surgical treatment of Hirschsprung's disease in children

Aim. To assess the safety, functional activity and quality of life of patients with Hirschsprung's disease operated by different methods. Methods. The study included 86 children operated on for Hirschsprung's disease. Patients were divided into four groups: group 1 - 44 (51.2%) patients underwent Duhamel-Martin procedure; group 2 - 14 (16.3%) patients underwent Soave-Boley procedure; group 3 - 22 (25.6%) patients underwent transanal endorectal resection; and group 4 - 16 (18.6%) patients underwent laparoscopical Soave-Georgeson procedure. The results were comparatively evaluated immediately and one year after the surgery. To assess the quality of life after surgery, a visual questionnaire Peds QLtm 4.0 was used. Results. Minimal duration of the surgery and related anesthesia was registered in groups 3 and 4, the difference with groups 2 and 3 being statistically significant (p <0.05). Duration of postoperative pain management in group 1 was 3.2±0.7 days, in group 2 - 3.3±0.7 days, while in groups 3 and 4 - 2.5±0.5 days (р ˂0.05). Minimal hospital stay after the surgery was registered in group 4 (9±2 days), which is less than in group 1 by 1.7 times, in group 2 - by 1,5 times (р ˂0.05). The second shortest hospital stay was observed in patients from group 3 (10±2 days): it was 1.4 and 1.3 times shorter tahn in groups 1 and 2, respectively (р ˂0.05). At the assessment of one-year functional results satisfactory results were obtained in group 1 in 20 (45.46%) patients, in group 2 - in 7 (50%), in group 3 - in 12 (54.55%), in group 4 - in 12 (75%) patients. Unfavorable results were observed in group 1 in 6 (13.64%) patients, in group 2 - in 2 (14.29%), in group 3 - in 2 (9.09%), in group 4 - in 0 (0%). The best quality of life according to all parameters was observed among patients from groups 3 and 4 (р ˂0.05). Conclusion. The quality of life of patients with Hirschsprung's disease after transanal endorectal resection and laparoscopic Soave-Georgeson procedure was higher than after Duhamel-Martin and Soave-Boley procedures; Soave-Boley procedure is preferable due to good regulation of the defecation act by patients.