Assessment of functional outcome in patients of Hirschprung’s disease following two stages Duhamel pull through

Purpose: The aim of this study was to assess the functional outcome in patients of Hirschprung's disease (HD) following two stages Duhamel pull through operation, that is levelling colostomy followed by the pull through. Materials and Methods: The study was conducted in the Department of Pediatric Surgery of a busy tertiary care children's hospital. Patients who completed the two stage Duhamel pull through operation at least 6 months prior and aged more than three years were included in the study. The quality of life (QOL) was assessed by using a questionnaire to the parents and clinical examination of the child. Continence status was assessed by applying the Krickenbeck Score. Results: Thirty patients were assessed after completion of two stage Duhamel pull through operation. Quality of life (QOL) was good in 27 patients (90%), fair in 2 patients (6.6%) and poor in 1 patient (3.3%). Voluntary Bowel Movement was present in 25 patients (83.3%) and absent in 5 patients (16.6%). Soiling was absent in 27 patients (90%) and present in 3 patients (10%). Among these 3 patients, 2 patients had grade 1 and 1 patient had grade 2 soiling. Constipation was absent in 26 patients (86.6%) and present in 4 patients (13.3%). Among these 4 patients, 1 patient had grade1 and 3 patients had grade 2 constipation. Conclusion: In patients of Hirschprung's disease, fecal continence and the quality of life was satisfactory after the two stage Duhamel pull through operation.