Long-term Follow-up of Patients with Hirschsprung Disease: Unusual Late Complications After Pull-through

Introduction: a large number of patients who undergo pull-through surgery due to hirschsprung disease (hd) are not surveilled properly postoperatively and suffer from various complications such as fecal soiling, constipation, etc. although some of these complications may resolve over time, it is rational to consider an evaluative protocol to identify anatomical or pathological complications in these patients. the present study aimed to evaluate and introduce the long-term postoperative complications of patients with hd. methods: in this historical cohort study, 193 patients with hd who had undergone pull-through surgery between 2006 to 2013 were considered. all files and questionnaires were used to collect patients’ information. the patients were also physically examined. the mean length of follow-up was 96.4±17.2 months, ranging from 60 to 144 months. follow-up was performed for all children through outpatient clinics or by phone. all statistical information was analyzed by spss software version 17. results: at first presentation, intestinal obstruction was more frequent than constipation. the most commonly involved segment was the rectosigmoid. the predominant early postoperative complication was stricture in the anal canal, while the most common late complications were constipation and fecal soiling. conclusion: the present longstanding follow-up study revealed anal stricture, enterocolitis, constipation, and fecal soiling to be the predominant long-term complications of hd following pull-through surgery. physicians should be aware of these issues and an appropriate long-term follow-up protocol should be devised. further studies assessing the long-term psychosocial complications of patients treated for hd seem warranted.