Abstract

Objective: Hirschsprung Disease (HD) is a neurocristopathy resulting from the migration failure of neural crest cells during intestinal development. It results in aganglionic colon and causes a functional constipation in children. We aimed to compare functional outcomes such as voluntary bowel movements, encopresis and constipation in patients with HD following Boley and Duhamel procedures.

Method: Patients who underwent pull through procedures using Boley or Duhamel methods were included in the study. All patients underwent a three-stage operation (opening of the ostomy, definitive operation and closure of the ostomy). Krickenbeck criteria were used to evaluate postoperative functional outcomes including voluntary bowel movements, soiling and constipation.

Results: Twenty-seven patients were male and 12 were female. 12 patients underwent Boley and 27 patients Duhamel procedure. In the majority of patients, the pathology was in the rectosigmoid region (n:28, 71.79%). The rates of voluntary bowel movement were 83.33% in the Boley and 85.18% in the Duhamel group. There was no statistically significant difference between the two groups (p>0.05). No significant difference was found between the two groups in terms of the frequency and degree of soiling (Duhamel 22.21%, and Boley 16.66%, p>0.05). In the Duhamel group, constipation was more frequent than Boley group (p<0.05).

Conclusion: Each technique has advantages and disadvantages compared to each other. In the majority of cases no serious complication is encountered, regardless of which technique is chosen for definitive surgery. It is recommended that the surgeon should continue to use the technique it is accustomed to and does well.

Atıf vermek için: Çelikkaya ME, Atıcı A, El Ç, Urfalı S, Akçora B. Hirschsprung hastalığında transabdominal duhamel ve boley prosedürlerinin karşılaştırmalı sonuçları. Çoc. Cer. Derg. 2019;33(2):45-9.