Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium
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- Delayed Hirschsprung diagnosis increases likelihood of requiring fecal diversion after initial pull-through surgery.
- Older age at diagnosis correlates with higher rates of postoperative constipation or incontinence requiring intervention.
- Age at diagnosis does not affect 30-day complication rates or need for pull-through revision.
- Multi-center data (679 patients, 14 sites) supports earlier diagnosis to optimize functional outcomes.
- Functional bowel outcomes appear more sensitive to diagnostic delay than immediate surgical complications.
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Does delayed diagnosis of Hirschrung disease affect postoperative and functional outcomes? I'm Alex Halpern, a research fellow from Children's National, and this is an article that you should know. The pediatric Colorectal and Pelvic Learning Consortium conducted a multi-center retrospective review from 2017 to 2023 trying to answer this question. They included 679 patients with Hirschprung disease from 14 different sites. They found that an increased age at diagnosis was associated with a greater likelihood of undergoing fecal diversion after initial pull through procedure. They also found that increased, A diagnosis was associated with an increased risk of constipation or incontinence requiring intervention postoperatively. They did not find an association between age at diagnosis and 30 day complication rate after initial pull through or need for pull through revision. So, it seems like delayed diagnosis of Hirschrung's disease does affect certain outcomes in these patients. Does this information change your practice at all? Let us know what you think in the comments below.