• Masato ShinkaiEmail author
  • Kyoko Mochizuki
  • Norihiko Kitagawa
  • Hidehito Usui


The majority of patients with Hirschsprung’s disease have an excellent postoperative outcome after definitive surgeries, i.e. classical pull-through procedures and contemporarily well-received minimally invasive procedures (laparoscopic or trans-anal approach).

Early postoperative complications and mortality are rare these days; however, later complications such as enterocolitis, constipation, and incontinence still remain an important issue affecting the quality of life of the patients. There have been a lot of unsolved questions with respect to correlation between surgical procedures and later complications, appropriate management for the complications (conservative or interventional), and how to prevent the complications. Close and long-term follow-up based on intra- or interinstitutionally shared standard of assessment and surgical procedures is mandatory to precisely analyze the outcomes and overcome those complications.


Hirschsprung’s disease Complication Postoperative Enterocolitis Constipation Incontinence Trans-abdominal Trans-anal Laparoscopic 


  1. 1.
    Zimmer J, Tomuschat C, Puri P. Long-term results of transanal pull-through for Hirschsprung’s disease: a meta-analysis. Pediatr Surg Int. 2016;32(8):743–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Tomuschat C, Zimmer J, Puri P. Laparoscopic-assisted pull-through operation for Hirschsprung’s disease: a systematic review and meta-analysis. Pediatr Surg Int. 2016;32(8):751–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Tannuri AC, Ferreira MA, Mathias AL, Tannuri U. Long-term results of the Duhamel technique are superior to those of the transanal pullthrough: a study of fecal continence and quality of life. J Pediatr Surg. 2017;52(3):449–53.CrossRefPubMedGoogle Scholar
  4. 4.
    Nasr A, Haricharan RN, Gamarnik J, Langer JC. Transanal pullthrough for Hirschsprung disease: matched case-control comparison of Soave and Swenson techniques. J Pediatr Surg. 2014;49(5):774–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Levitt MA, Dickie B, Pena A. Evaluation and treatment of the patient with Hirschsprung disease who is not doing well after a pull-through procedure. Semin Pediatr Surg. 2010;19(2):146–53.CrossRefPubMedGoogle Scholar
  6. 6.
    Aworanti OM, McDowell DT, Martin IM, Quinn F. Does functional outcome improve with time postsurgery for Hirschsprung disease? Eur J Pediatr Surg. 2016;26(2):192–9.PubMedGoogle Scholar
  7. 7.
    Neuvonen MI, Kyrklund K, Rintala RJ, Pakarinen MP. Bowel function and quality of life after transanal endorectal pull-through for Hirschsprung disease: controlled outcomes up to adulthood. Ann Surg. 2017;265(3):622–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Skinner MA. Hirschsprung disease. Curr Prob Surg. 1996;33(5):389–460.CrossRefGoogle Scholar
  9. 9.
    Shono KHJ. The treatment and postoperative complications of Hirschsprung’s disease. Pediatr Surg Int. 1994;9:362–5.CrossRefGoogle Scholar
  10. 10.
    Feng C, Sidhwa F, Cameron DB, Glass C, Rangel SJ. Rates and burden of surgical site infections associated with pediatric colorectal surgery: insight from the National Surgery Quality Improvement Program. J Pediatr Surg. 2016;51(6):970–4.CrossRefPubMedGoogle Scholar
  11. 11.
    Rescorla FJ, Morrison AM, Engles D, West KW, Grosfeld JL. Hirschspurng’s disease. Evaluation of mortality and long-term function in 260 cases. Arch Surg. 1992;127(8):934–41.CrossRefPubMedGoogle Scholar
  12. 12.
    Sherman JO, Snyder ME, Weitzman JJ, Jona JZ, Gillis DA, O’Donnell B, et al. A 40-year multinational retrospective study of 880 Swenson procedures. J Pediatr Surg. 1989;24(8):833–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Bourdelat D, Vrsansky P, Pages R, Duhamel B. Duhamel operation 40 years after: a multicentric study. Eur J Pediatr Surg. 1997;7(2):70–6.CrossRefPubMedGoogle Scholar
  14. 14.
    Seo S, Miyake H, Hock A, Koike Y, Yong C, Lee C, et al. Duhamel and transanal endorectal pull-throughs for Hirschsprung’ disease: a systematic review and meta-analysis. Eur J Pediatr Surg. 2018;28(1):81–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Levitt MA, Hamrick MC, Eradi B, Bischoff A, Hall J, Pena A. Transanal, full-thickness, Swenson-like approach for Hirschsprung disease. J Pediatr Surg. 2013;48(11):2289–95.CrossRefPubMedGoogle Scholar
  16. 16.
    Austin KM. The pathogenesis of Hirschsprung’s disease-associated enterocolitis. Semin Pediatr Surg. 2012;21(4):319–27.CrossRefPubMedGoogle Scholar
  17. 17.
    Swenson O, Sherman JO, Fisher JH, Cohen E. The treatment and postoperative complications of congenital megacolon: a 25 year followup. Ann Surg. 1975;182(3):266–72.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Vieten D, Spicer R. Enterocolitis complicating Hirschsprung’s disease. Semin Pediatr Surg. 2004;13(4):263–72.CrossRefPubMedGoogle Scholar
  19. 19.
    Teitelbaum DH, Cilley RE, Sherman NJ, Bliss D, Uitvlugt ND, Renaud EJ, et al. A decade of experience with the primary pull-through for Hirschsprung disease in the newborn period: a multicenter analysis of outcomes. Ann Surg. 2000;232(3):372–80.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Kleinhaus SK, Boley SJ, Sheran M, Sieber WK. Hirschsprung’s disease. A survey of the members of the Surgical Section of the American Academy of Pediatrics. J Pediatri Surg. 1979;14(5).Google Scholar
  21. 21.
    Pini Prato A, Rossi V, Avanzini S, Mattioli G, Disma N, Jasonni V. Hirschsprung’s disease: what about mortality? Pediatr Surg Int. 2011;27(5):473–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Pastor AC, Osman F, Teitelbaum DH, Caty MG, Langer JC. Development of a standardized definition for Hirschsprung’s-associated enterocolitis: a Delphi analysis. J Pediatr Surg. 2009;44(1):251–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Pontarelli EM, Ford HR, Gayer CP. Recent developments in Hirschsprung’s-associated enterocolitis. Curr Gastroenterol Rep. 2013;15(8):340.CrossRefPubMedGoogle Scholar
  24. 24.
    Elhalaby EA, Coran AG, Blane CE, Hirschl RB, Teitelbaum DH. Enterocolitis associated with Hirschsprung’s disease: a clinical-radiological characterization based on 168 patients. J Pediatr Surg. 1995;30(1):76–83.CrossRefPubMedGoogle Scholar
  25. 25.
    Gosain A, Frykman PK, Cowles RA, Horton J, Levitt M, Rothstein DH, et al. Guidelines for the diagnosis and management of Hirschsprung-associated enterocolitis. Pediatr Surg Int. 2017;33(5):517–21.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Moore SW, Albertyn R, Cywes S. Clinical outcome and long-term quality of life after surgical correction of Hirschsprung’s disease. J Pediatr Surg. 1996;31(11):1496–502.CrossRefPubMedGoogle Scholar
  27. 27.
    Menezes M, Puri P. Long-term outcome of patients with enterocolitis complicating Hirschsprung’s disease. Pediatr Surg Int. 2006;22(4):316–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Teitelbaum DH, Qualman SJ, Caniano DA. Hirschsprung’s disease. Identification of risk factors for enterocolitis. Ann Surg. 1988;207(3):240–4.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Travassos D, van Herwaarden-Lindeboom M, van der Zee DC. Hirschsprung’s disease in children with Down syndrome: a comparative study. Eur J Pediatr Surg. 2011;21(4):220–3.CrossRefPubMedGoogle Scholar
  30. 30.
    Langer JC, Durrant AC, de la Torre L, Teitelbaum DH, Minkes RK, Caty MG, et al. One-stage transanal Soave pullthrough for Hirschsprung disease: a multicenter experience with 141 children. Ann Surg. 2003;238(4):569–83. discussion 83–5.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Martins EC, Peterlini FL, Fagundes DJ, Martins JL. Clinical, manometric and profilometric evaluation after surgery for Hirschsprung’s disease: comparison between the modified Duhamel and the transanal rectosigmoidectomy techniques. Acta Cir Bras. 2009;24(5):416–22.CrossRefPubMedGoogle Scholar
  32. 32.
    De la Torre L, Cogley K, Santos K, Morales O, Calisto J. The anal canal is the fine line between "fecal incontinence and colitis" after a pull-through for Hirschsprung disease. J Pediatr Surg. 2017;52(12):2011–7.CrossRefPubMedGoogle Scholar
  33. 33.
    Frykman PK, Short SS. Hirschsprung-associated enterocolitis: prevention and therapy. Semin Pediatr Surg. 2012;21(4):328–35.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Marty TL, Seo T, Sullivan JJ, Matlak ME, Black RE, Johnson DG. Rectal irrigations for the prevention of postoperative enterocolitis in Hirschsprung’s disease. J Pediatr Surg. 1995;30(5):652–4.CrossRefPubMedGoogle Scholar
  35. 35.
    El-Sawaf M, Siddiqui S, Mahmoud M, Drongowski R, Teitelbaum DH. Probiotic prophylaxis after pullthrough for Hirschsprung disease to reduce incidence of enterocolitis: a prospective, randomized, double-blind, placebo-controlled, multicenter trial. J Pediatr Surg. 2013;48(1):111–7.CrossRefPubMedGoogle Scholar
  36. 36.
    Kapur RP, Kennedy AJ. Transitional zone pull through: surgical pathology considerations. Semin Pediatr Surg. 2012;21(4):291–301.CrossRefPubMedGoogle Scholar
  37. 37.
    Teitelbaum DH, Coran AG. Reoperative surgery for Hirschsprung’s disease. Semin Pediatr Surg. 2003;12(2):124–31.CrossRefPubMedGoogle Scholar
  38. 38.
    Langer JC. Persistent obstructive symptoms after surgery for Hirschsprung’s disease: development of a diagnostic and therapeutic algorithm. J Pediatr Surg. 2004;39(10):1458–62.CrossRefPubMedGoogle Scholar
  39. 39.
    Pini-Prato A, Mattioli G, Giunta C, Avanzini S, Magillo P, Bisio GM, et al. Redo surgery in Hirschsprung disease: what did we learn? Unicentric experience on 70 patients. J Pediatr Surg. 2010;45(4):747–54.CrossRefPubMedGoogle Scholar
  40. 40.
    Minkes RK, Langer JC. A prospective study of botulinum toxin for internal anal sphincter hypertonicity in children with Hirschsprung’s disease. J Pediatr Surg. 2000;35(12):1733–6.CrossRefPubMedGoogle Scholar
  41. 41.
    Patrus B, Nasr A, Langer JC, Gerstle JT. Intrasphincteric botulinum toxin decreases the rate of hospitalization for postoperative obstructive symptoms in children with Hirschsprung disease. J Pediatr Surg. 2011;46(1):184–7.CrossRefPubMedGoogle Scholar
  42. 42.
    Koivusalo AI, Pakarinen MP, Rintala RJ. Botox injection treatment for anal outlet obstruction in patients with internal anal sphincter achalasia and Hirschsprung’s disease. Pediatr Surg Int. 2009;25(10):873–6.CrossRefPubMedGoogle Scholar
  43. 43.
    Polley TZ Jr, Coran AG, Wesley JR. A ten-year experience with ninety-two cases of Hirschsprung’s disease. Including sixty-seven consecutive endorectal pull-through procedures. Ann Surg. 1985;202(3):349–55.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Weber TR, Fortuna RS, Silen ML, Dillon PA. Reoperation for Hirschsprung’s disease. J Pediatr Surg. 1999;34(1):153–6.CrossRefPubMedGoogle Scholar
  45. 45.
    Wildhaber BE, Pakarinen M, Rintala RJ, Coran AG, Teitelbaum DH. Posterior myotomy/myectomy for persistent stooling problems in Hirschsprung’s disease. J Pediatr Surg. 2004;39(6):920–6. discussion-6.CrossRefPubMedGoogle Scholar
  46. 46.
    Rintala RJ, Pakarinen MP. Long-term outcomes of Hirschsprung’s disease. Semin Pediatr Surg. 2012;21(4):336–43.CrossRefPubMedGoogle Scholar
  47. 47.
    Puri P, Nixon HH. Long-term results of Swenson’s operation for Hirschsprung’s disease. Prog Pediatr Surg. 1977;10:87–96.PubMedGoogle Scholar
  48. 48.
    Marty TL, Seo T, Matlak ME, Sullivan JJ, Black RE, Johnson DG. Gastrointestinal function after surgical correction of Hirschsprung’s disease: long-term follow-up in 135 patients. J Pediatr Surg. 1995;30(5):655–8.CrossRefPubMedGoogle Scholar
  49. 49.
    Menezes M, Corbally M, Puri P. Long-term results of bowel function after treatment for Hirschsprung’s disease: a 29-year review. Pediatr Surg Int. 2006;22(12):987–90.CrossRefPubMedGoogle Scholar
  50. 50.
    Dickie BH, Webb KM, Eradi B, Levitt MA. The problematic Soave cuff in Hirschsprung disease: manifestations and treatment. J Pediatr Surg. 2014;49(1):77–80. discussion-1.CrossRefPubMedGoogle Scholar
  51. 51.
    Nasr A, Langer JC. Evolution of the technique in the transanal pull-through for Hirschsprung’s disease: effect on outcome. J Pediatr Surg. 2007;42(1):36–9. discussion 9-40.CrossRefPubMedGoogle Scholar
  52. 52.
    Suita S, Taguchi T, Yanai K, Kamimura T, Nakao M, Ikeda K. Longterm outcomes and quality of life after Z-shaped anastomosis for Hirschsprung’s disease. J Am Coll Surg. 1998;187(6):577–83.CrossRefPubMedGoogle Scholar
  53. 53.
    Farrugia MK, Alexander N, Clarke S, Nash R, Nicholls EA, Holmes K. Does transitional zone pull-through in Hirschsprung’s disease imply a poor prognosis? J Pediatr Surg. 2003;38(12):1766–9.CrossRefPubMedGoogle Scholar
  54. 54.
    Proctor ML. Correlation between radiographic transition zone and level of aganglionosis in Hirschsprung’s disease—implications for surgical approach. J Pediatr Surg. 2003;38:775–8.CrossRefPubMedGoogle Scholar
  55. 55.
    White FV, Langer JC. Circumferential distribution of ganglion cells in the transition zone of children with Hirschsprung disease. Pediatr Dev Pathol. 2000;3(3):216–22.CrossRefPubMedGoogle Scholar
  56. 56.
    Shayan K, Smith C, Langer JC. Reliability of intraoperative frozen sections in the management of Hirschsprung’s disease. J Pediatr Surg. 2004;39(9):1345–8.CrossRefPubMedGoogle Scholar
  57. 57.
    West KW, Grosfeld JL, Rescorla FJ, Vane DW. Acquired aganglionosis: a rare occurrence following pull-through procedures for Hirschsprung’s disease. J Pediatr Surg. 1990;25(1):104–8. discussion 8-9.CrossRefPubMedGoogle Scholar
  58. 58.
    Cohen MC, Moore SW, Neveling U, Kaschula RO. Acquired aganglionosis following surgery for Hirschsprung’s disease: a report of five cases during a 33-year experience with pull-through procedures. Histopathology. 1993;22(2):163–8.CrossRefPubMedGoogle Scholar
  59. 59.
    Di Lorenzo C, Solzi GF, Flores AF, Schwankovsky L, Hyman PE. Colonic motility after surgery for Hirschsprung’s disease. Am J Gastroenterol. 2000;95(7):1759–64.CrossRefPubMedGoogle Scholar
  60. 60.
    Meinds RJ, Eggink MC, Heineman E, Broens PM. Dyssynergic defecation may play an important role in postoperative Hirschsprung’s disease patients with severe persistent constipation: analysis of a case series. J Pediatr Surg. 2014;49(10):1488–92.CrossRefPubMedGoogle Scholar
  61. 61.
    De La Torre L, Langer JC. Transanal endorectal pull-through for Hirschsprung disease: technique, controversies, pearls, pitfalls, and an organized approach to the management of postoperative obstructive symptoms. Semin Pediatr Surg. 2010;19(2):96–106.CrossRefGoogle Scholar
  62. 62.
    Keshtgar AS, Ward HC, Clayden GS, de Sousa NM. Investigations for incontinence and constipation after surgery for Hirschsprung’s disease in children. Pediatr Surg Int. 2003;19(1–2):4–8.PubMedGoogle Scholar
  63. 63.
    Zaskavsky C, Reverbel da Silveira T, Maguilnik I. Total and segmental colonic transit time with radio-opaque markers in adolescents with functional constipation. J Pediar Gastroenterol Nutr. 1998;27(2):138–42.CrossRefGoogle Scholar
  64. 64.
    Southwell BR, Clarke MC, Sutcliffe J, Hutson JM. Colonic transit studies: normal values for adults and children with comparison of radiological and scintigraphic methods. Pediatr Surg Int. 2009;25(7):559–72.CrossRefPubMedGoogle Scholar
  65. 65.
    Joensson IM, Siggaard C, Rittig S, Hagstroem S, Djurhuus JC. Transabdominal Ultrasound of Rectum as a Diagnostic Tool in Childhood Constipation. J Urol. 2008;179(5):1997–2002.Google Scholar
  66. 66.
    Ralls MW, Coran AG, Teitelbaum DH. Reoperative surgery for Hirschsprung disease. Semin Pediatr Surg. 2012;21(4):354–63.CrossRefPubMedGoogle Scholar
  67. 67.
    Blair GK, Murphy JJ, Fraser GC. Internal sphincterotomy in post-pull-through Hirschsprung’s disease. J Pediatr Surg. 1996;31:843–5.CrossRefPubMedGoogle Scholar
  68. 68.
    Langer JC, Rollins MD, Levitt M, Gosain A, Torre L, Kapur RP, et al. Guidelines for the management of postoperative obstructive symptoms in children with Hirschsprung disease. Pediatr Surg Int. 2017;33(5):523–6.CrossRefPubMedGoogle Scholar
  69. 69.
    Wester T, Granstrom AL. Botulinum toxin is efficient to treat obstructive symptoms in children with Hirschsprung disease. Pediatr Surg Int. 2015;31(3):255–9.CrossRefPubMedGoogle Scholar
  70. 70.
    Aworanti OM, McDowell DT, Martin IM, Hung J, Quinn F. Comparative review of functional outcomes post surgery for Hirschsprung’s disease utilizing the paediatric incontinence and constipation scoring system. Pediatr Surg Int. 2012;28(11):1071–8.CrossRefPubMedGoogle Scholar
  71. 71.
    Ieiri S, Nakatsuji T, Akiyoshi J, Higashi M, Hashizume M, Suita S, et al. Long-term outcomes and the quality of life of Hirschsprung disease in adolescents who have reached 18 years or older—a 47-year single-institute experience. J Pediatr Surg. 2010;45(12):2398–402.CrossRefPubMedGoogle Scholar
  72. 72.
    Travassos DV, Bax NM, Van der Zee DC. Duhamel procedure: a comparative retrospective study between an open and a laparoscopic technique. Surg Endosc. 2007;21(12):2163–5.CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    Minford JL, Ram A, Turnock RR, Lamont GL, Kenny SE, Rintala RJ, et al. Comparison of functional outcomes of Duhamel and transanal endorectal coloanal anastomosis for Hirschsprung’s disease. J Pediatr Surg. 2004;39(2):161–5. discussion -5.CrossRefPubMedGoogle Scholar
  74. 74.
    Zhang SC, Bai YZ, Wang W, Wang WL. Long-term outcome, colonic motility, and sphincter performance after Swenson’s procedure for Hirschsprung’s disease: a single-center 2-decade experience with 346 cases. Am J Surg. 2007;194(1):40–7.CrossRefPubMedGoogle Scholar
  75. 75.
    Stathopoulos L, King SK, Southwell BR, Hutson JM. Nuclear transit study in children with chronic faecal soiling after Hirschsprung disease (HSCR) surgery has revealed a group with rapid proximal colonic treatment and possible adverse reactions to food. Pediatr Surg Int. 2016;32(8):773–7.CrossRefPubMedGoogle Scholar
  76. 76.
    El-Sawaf MI, Drongowski RA, Chamberlain JN, Coran AG, Teitelbaum DH. Are the long-term results of the transanal pull-through equal to those of the transabdominal pull-through? A comparison of the 2 approaches for Hirschsprung disease. J Pediatr Surg. 2007;42(1):41–7. discussion 7.CrossRefPubMedGoogle Scholar
  77. 77.
    Gosemann JH, Friedmacher F, Ure B, Lacher M. Open versus transanal pull-through for Hirschsprung disease: a systematic review of long-term outcome. Eur J Pediatr Surg. 2013;23(2):94–102.CrossRefPubMedGoogle Scholar
  78. 78.
    Bischoff A, Frischer J, Knod JL, Dickie B, Levitt MA, Holder M, et al. Damaged anal canal as a cause of fecal incontinence after surgical repair for Hirschsprung disease—a preventable and under-reported complication. J Pediatr Surg. 2017;52(4):549–53.CrossRefPubMedGoogle Scholar
  79. 79.
    Raffensperger J. Letter to the Editor. J Pediatr Surg. 2018;53(7):1446.CrossRefPubMedGoogle Scholar
  80. 80.
    Miyano G, Koga H, Okawada M, Doi T, Sueyoshi R, Nakamura H, et al. Rectal mucosal dissection commencing directly on the anorectal line versus commencing above the dentate line in laparoscopy-assisted transanal pull-through for Hirschsprung’s disease: prospective medium-term follow-up. J Pediatr Surg. 2015;50(12):2041–3.CrossRefPubMedGoogle Scholar
  81. 81.
    Stensrud KJ, Emblem R, Bjornland K. Anal endosonography and bowel function in patients undergoing different types of endorectal pull-through procedures for Hirschsprung disease. J Pediatr Surg. 2015;50(8):1341–6.CrossRefPubMedGoogle Scholar
  82. 82.
    Yanchar NL, Soucy P. Long-term outcome after Hirschsprung’s disease: patients’ perspectives. J Pediatr Surg. 1999;34(7):1152–60.CrossRefPubMedGoogle Scholar
  83. 83.
    Frischer JS, Rymeski B. Complications in colorectal surgery. Semin Pediatr Surg. 2016;25(6):380–7.CrossRefPubMedGoogle Scholar
  84. 84.
    Levitt MA, Dickie B, Pena A. The Hirschsprungs patient who is soiling after what was considered a "successful" pull-through. Semin Pediatr Surg. 2012;21(4):344–53.CrossRefPubMedGoogle Scholar
  85. 85.
    Yasui Y, Nishida S, Shironomae T, Satomi M, Kuwahara T, Kohno M. Surgical approach for fecal incontinence with a patulous anus after transanal pull-through for Hirschsprung disease. J Pediatr Surg. 2017;52(6):1070–5.CrossRefPubMedGoogle Scholar
  86. 86.
    Kessler BH, So HB, Becker JM. Crohn’s disease mimicking enterocolitis in a patient with an endorectal pull-through for Hirschsprung’s disease. J Pediatr Gastroenterol Nutr. 1999;29(5):601–3.CrossRefPubMedGoogle Scholar
  87. 87.
    Nakamura H, Lim T, Puri P. Inflammatory bowel disease in patients with Hirschsprung’s disease: a systematic review and meta-analysis. Pediatr Surg Int. 2018;34(2):149–54.CrossRefPubMedGoogle Scholar
  88. 88.
    Versteegh HP, Johal NS, de Blaauw I, Stanton MP. Urological and sexual outcome in patients with Hirschsprung disease: a systematic review. J Pediatr Urol. 2016;12(6):352–60.CrossRefPubMedGoogle Scholar
  89. 89.
    Granstrom AL, Danielson J, Husberg B, Nordenskjold A, Wester T. Adult outcomes after surgery for Hirschsprung’s disease: Evaluation of bowel function and quality of life. J Pediatr Surg. 2015;50(11):1865–9.CrossRefPubMedGoogle Scholar
  90. 90.
    Lof Granstrom A, Wester T. Mortality in Swedish patients with Hirschsprung disease. Pediatr Surg Int. 2017;33(11):1177–81.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Masato Shinkai
    • 1
    Email author
  • Kyoko Mochizuki
    • 1
  • Norihiko Kitagawa
    • 1
  • Hidehito Usui
    • 1
  1. 1.Kanagawa Children’s Medical CenterYokohamaJapan

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