86 | wetenschapsdag 2023 Sessie 3a: Holl(t)en of Stilstaan x2 Auteurs S.P. van Streun, J.P.M. Derikx, L.W.E. van Heurn Abstract titel The development of fecal continence in children surgically treated for Hirschsprung disease. Background Fecal continence is an important goal in the postoperative management of children with Hirschsprung disease (HD). However, previous studies focus on postoperative fecal incontinence in children with HD. Therefore, the aim of this study was to investigated the development of postoperative fecal continence in children with HD. Methods Fecal continence was measured in a prospective cohort follow-up program for children with HD. We included children aged between 4-18 years and operatively treated with Pull-through or Duhamel technique. Children with Down Syndrome, stoma or treated after the age of years were excluded. Fecal continence was considered present if no signs of fecal incontinence classified by Rome IV criteria were present. Each child was categorized as incontinent, continent or pseudo-continent (i.e. need for anal irrigations to be continent). Statistical analyses were performed using median and IQR for age and Kaplan-Meier survival analysis status of continence. Results Hundred children were included in this study. 77 children were fecal continent, 14 children pseudo-continent and 9 children fecal incontinent. The median age of achieving fecal continence was four years (IQR 2). Kaplan-Meyer survival analysis showed that 48 children achieved fecal continence at the age of four years and 70 children at the age of seven years And 7 children at the age of fourteen years. During this follow-up 11 out of 77 children had a relapse of fecal incontinence. The overall median follow-up time was seven years (IQR 6). The median follow-up time for pseudocontinent was nine years (IQR 4). Conclusion The vast majority of children achieve fecal continence at the age of four years after surgical treatment for HD with the possibility of relapse to fecal incontinence.
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