LONG-TERM STOOLING PATTERNS IN INFANTS UNDERGOING PRIMARY ENDORECTAL PULL-THROUGH FOR HIRSCHSPRUNGS-DISEASE

Primary endorectal pull-through (ERPT) has become an increasingly popu lar method of caring for neonates and young infants who have Hirschspr ung's disease. This study evaluated the long-term stooling patterns an d continence rates of patients who had a primary ERPT as a young infan t, The records of 24 infants who underwent a primary ERPT for Hirschsp rung's disease were reviewed. The patients' families (those patients o ver 3 years of age, n = 12) underwent a detailed interview that graded continence from 0 (poor) to 10 (normal). Mean age at ERPT was 15 +/- 17 days (range, 2 to 67). Mean follow-up was 1,036 +/- 614 days, Nine patients suffered from 20 episodes of enterocolitis, Stooling frequenc y declined rapidly in the first 6 months after the ERPT (r(2) = 1.00) and more slowly after this time (r(2) = 0.79). Continence was graded a s normal (10) in one, good (6 to 9 points) in nine, and fair (1 to 5) in two patients, both of whom had total colonic disease. The authors c onclude that a primary ERPT in the young infant who has Hirschsprung's disease can yield excellent results including normalization of stooli ng frequency and good to excellent levels of continence. Copyright (C) 1997 by W.B. Saunders Company.