Journal
JOURNAL OF PEDIATRIC SURGERY
Volume 52, Issue 12, Pages 2006-2010Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jpedsurg.2017.08.043
Keywords
Hirschsprung disease; Quality of life; Fecal incontinence; Constipation; Bowel function
Categories
Funding
- Royal Children's Hospital Foundation
- Career Development Award (Murdoch Children's Research Institute)
- Senior Lecturer Fellowship (Royal Australasian College of Surgeons)
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Background: Morbidity following repair of Hirschsprung disease (HD) is common. However, quality of life (QoL) results focused on HD children are contradictory. We aimed to measure QoL outcomes in HD children using validated questionnaires. Methods: Patients with HD, managed at a large tertiary pediatric institution between 2004 and 2013, were identified. Parents completed validated questionnaires. Results were compared with published healthy population controls. QoL outcomes were measured using Pediatric Quality of Life (PedsQL) and Fecal Incontinence and Constipation Quality of Life (FIC QOL). Functional outcomes were assessed using Baylor Continence Scale, Cleveland Clinic Constipation Scoring System, and Vancouver Dysfunctional Elimination Syndrome Survey. Results: Parents of 60 HD patients [M: F 49: 11; median age 6.4 years (2.3-10.9)] were interviewed (59% participation). The majority (47/60, 78%) had rectosigmoid disease. There was significant reduction in psychosocial (social and emotional) QoL compared with healthy children (p = 0.03). Psychosocial functioning was affected by increasing age (r = -2.72, p < 0.001), fecal incontinence (r = -0.475, p = 0.007), constipation (r = -1.58, p = 0.006), and dysfunctional elimination (r = -2.94, p = 0.004). Fecal incontinence also reduced physical functioning QoL (r = -0.306, p = 0.007). Children with HD had significantly higher levels of fecal incontinence (p < 0.01). Conclusions: Wehave demonstrated that HD children have significant reductions in psychosocial QoL and functional outcomes. (C) 2017 Elsevier Inc. All rights reserved.
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