Perioperative and Long‐Term Functional Outcomes of Children With Early Diagnosis Versus Late Diagnosis of Hirschsprung′s Disease: A 30‐Year Monocentric Retrospective Study

Purpose The purpose of this study was to compare the perioperative course and long‐term functional outcomes of children with early and late diagnosis of Hirschsprung′s disease (HD). Methods This retrospective study included patients affected by HD who underwent pull‐through between 1984 and 2015. Patients were classified into two groups: early diagnosis of HD (EDHD) before 1 year of age and late diagnosis of HD (LDHD) after 1 year. Functional outcomes at 3, 6, and 9 years after surgery were analyzed. Results One hundred and five patients, 83.8% with EDHD and 16.2% with LDHD. Abdominal distension and vomiting were the main presenting symptoms of EDHD, whereas chronic constipation was the primary symptom of LDHD. Preoperative intestinal obstruction occurred in 59.1% of EDHD versus 5.9% of LDHD ( p < 0.0001). Diverting colostomy was performed in 31.8% of EDHD versus 5.9% in LDHD ( p = 0.03). Anal strictures needing anal dilatation occurred in 30.7% of EDHD versus 5.9% in LDHD ( p = 0.03). At 3 years of follow‐up, there was a statistical difference in terms of constipation (10% in EDHD vs. 23.5% in LDHD; p = 0.04), but not in terms of soiling (30.7% vs. 29.4%; p = 0.65); 9 years after surgery, comparable results were shown in terms of both constipation and soiling. Conclusion Long‐term functional outcome is generally comparable between patients with EDHD and LDHD.