Children’s Life Quality With Hirsprung's Disease After Operation De La Torre-Ortega

Abstract

Hirschsprung's disease (or aganglionosis) is a congenital disease in which intestinal ganglia (nerve bundles) are absent in the rectum, sigmoid and colon.

Purpose of the study: To investigate the functional activity and well-being indicators in children diagnosed with Hirschsprung's disease who have undergone the De La Torre-Ortega procedure.

Materials and methods: The research comprised 89 children diagnosed with Hirschsprung's disease who underwent surgical intervention at the pediatric surgery clinic of Andizhan state medical institute between 2015 and 2022. The patients' ages ranged from 2 to 18 years;17 (19.1%) children were in the decompensated stage, 51 (57.3%) were in the subcompensated stage and 21 (23.5%) were in the compensated stage; 55 (61.8%) children were operated on using the modified De La Torre-Ortega technique, 34 (38.2%) - using the classic Soave-Lenyushkin transanal colectomy technique. Living conditions and experiences of the operated children was assessed using the PedsQL™ 4.0 scale, consisting of 21 questions evaluating physical, emotional, social, and role performance.

Results: Analysis of the quality of life of children with Hirschsprung's disease showed a significant increase in indicators on all scales one year after surgical treatment, while the degree of improvement was higher (p<0.05) when performing the improved technique of the De La Torre-Ortega operation (from an average of 62.0 -70.8% on all scales before surgery to 84.1-92.3% in relation to the group of healthy children) with a change in the total score from 52.8±10.0 to 70.4±6.4 (t= 6.79; p<0.001), in turn, transanal resection of the colon using the classical Soave-Lenyushkin method allowed achieving compliance with the group of healthy children at an average level of 76.7-84.7% with an increase in the total score only to 64 .3±4.4.

Conclusion: Improving the tactical and technical aspects of the surgical management of Hirschsprung's disease in children in combination with a complex postoperative rehabilitation program can improve the functional prognosis.