{Reference Type}: Journal Article
{Title}: Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium.
{Author}: Ullrich S;Austin K;Avansino JR;Badillo A;Calkins CM;Crady RC;Durham MM;Fuller MK;Rana A;Reeder RW;Rentea RM;Rollins MD;Saadai P;Speck KE;Wood RJ;van Leeuwen K;Frischer JS; ;
{Journal}: J Pediatr Surg
{Volume}: 59
{Issue}: 7
{Year}: 2024 Jul 18
{Factor}: 2.549
{DOI}: 10.1016/j.jpedsurg.2024.03.034
{Abstract}: BACKGROUND: Hirschsprung Disease (HD) is a rare cause of functional bowel obstruction in children. Patients are typically diagnosed in the neonatal period and undergo pull-through (PT) soon after diagnosis. The optimal management and post-operative outcomes of children who present in a delayed fashion are unknown.
METHODS: A multi-center retrospective review of children with HD was performed at participating Pediatric Colorectal and Pelvic Learning Consortium sites. Children were stratified by age at diagnosis (neonates <29 days; infants 29 days-12 months; toddler 1 year-5 years and child >5 years).
RESULTS: 679 patients with HD from 14 sites were included; Most (69%) were diagnosed in the neonatal period. Age at diagnosis was not associated with differences in 30-day complication rates or need for PT revision. Older age at diagnosis was associated with a greater likelihood of undergoing fecal diversion after PT (neonate 10%, infant 12%, toddler 26%, child 28%, P < 0.001) and a greater need for intervention for constipation or incontinence postoperatively (neonate 56%, infant 62%, toddler 78%, child 69%, P < 0.001).
CONCLUSIONS: Delayed diagnosis of HD does not impact 30-day post-operative outcomes or need for revision surgery but, delayed diagnosis is associated with increased need for fecal diversion after pull-through.
METHODS: III.