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Long-Term Surgical Outcomes and Adulthood Transitional Care Planning for Hirschsprung’s Disease: A Single-Center Retrospective Study

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Tokarska K., Saryusz-Romiszewski M., Smolec-Zamora M., Bogusz B., Górecki W.

Polish Journal of Surgery

2024

vol. 97

issue 1

1-6

Introduction: Hirschsprung's disease, despite its typical diagnosis and surgical treatment in infancy, profoundly impacts the lifelong health of affected individuals. There is a growing recognition of the necessity to establish a structured transition process for patients transitioning from pediatric to general surgical care, with the inclusion of gastroenterologists and psychologists in this process. Aim: This study aimed to characterize the demographic profile of patients who underwent surgery for Hirschsprung's disease, assess prevalent complications, determine reoperation rates, and evaluate the demand for gastroenterological care. Materials and methods: A retrospective analysis was conducted on data from adolescents and young adults born between 2000 and 2013 who underwent surgery for Hirschsprung's disease at the University Children's Hospital of Krakow, totaling 119 children meeting the inclusion criteria. Results: Findings reveal that despite active management by pediatric surgeons, follow-up duration remains insufficient, with 38.9% of patients monitored only until the age of 5. As many as 31.8% of patients were consulted by a pediatric surgeon during adolescence, and only 15% just before turning 18. Concurrent gastroenterological conditions were identified in 15.8% of patients, emphasizing the potential benefit of early diagnosis in symptom management. As many as 18.4% of patients required a procedure under general anesthesia, with 9.6% undergoing major abdominal surgery. Special attention should be given to patients with Crohn's disease and anorectal malformation. They require regular monitoring and multidisciplinary care. Conclusions: Patients treated for Hirschsprung's disease require long-term follow-up and a personalized approach, taking into account the possibility of additional conditions and the need for further medical interventions. Developing a standardized transition process is crucial, involving collaboration within a multidisciplinary team. Special attention should be given to patients with comorbidities, as they face an elevated risk of complications.

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1 Polish Journal of Surgery

1 2024

1 Bogusz B.

1 Górecki W.

1 Saryusz-Romiszewski M.

1 Smolec-Zamora M.

1 Tokarska K.

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Long-Term Surgical Outcomes and Adulthood Transitional Care Planning for Hirschsprung’s Disease: A Single-Center Retrospective Study