Quality of life and parents’ satisfaction with Duhamel’s versus transanal endorectal pull-through for the treatment of Hirschsprung’s disease in children

Abstract

Background The aim of this study is to compare the surgical outcome as well as parents’ satisfaction and quality of life for children after the transanal and the Duhamel pull-through operations in a single-center experience.
Patients and methods A retrospective cohort file review was carried out of all cases of Hirschsprung’s disease treated surgically in our institution. Patients were classified into group 1 (transanal endorectal pull-through) and group 2 (Duhamel pull-through). Three questionnaires were designed. Demographic data, perioperative data, complications, and the length of follow-up data were analyzed statistically.
Results Six-nine patients were included. Medications were required postoperatively in 27% of the patients in group 1 versus 60.7% of patients in group 2. In group 1, 22.5% of parents were fairly satisfied and 69% of parents were satisfied, whereas in group 2, 31.8% of parents were poorly satisfied, 40.9% were fairly satisfied, and 27.3% were satisfied. Patients were older than 3 years; no patients had poor results in group 1 versus 33.3% in group 2.
Conclusion Our experience with transanal pull-through showed less incidence of postoperative enterocolitis, failure to thrive, redo surgery, and need for anticonstipation medications than that with Duhamel pull-through. Although the anorectal scoring system showed better results in transanal pull-through than Duhamel pull-through in all age groups, it was statistically significant in patients older than 3 years of age. There was a statistically significantly better parent satisfaction and quality of life in the transanal group than the Duhamel pull-through group. 

Keywords: Hirschsprung’s disease, parent satisfaction, quality of life and children