Demirtas G, Ekberli G, Tiryaki HT. Anorectal changes and clinical outcomes after the Duhamel operation. World J Gastrointest Surg 2026; 18(1): 115171 [DOI: 10.4240/wjgs.v18.i1.115171]
Corresponding Author of This Article
Gunay Ekberli, MD, Associate Professor, Department of Pediatric Urology, Ankara Bilkent City Hospital, Üniversiteler Cad. Bilkent Şehir Hastanesi, Ankara 06800, Cankaya, Türkiye. gnyekbrl@yahoo.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Gokhan Demirtas, Department of Pediatric Urology, Ministry of Health Ankara Sincan Government Hospital, Ankara 06934, Cankaya, Türkiye
Gunay Ekberli, Huseyın Tugrul Tiryaki, Department of Pediatric Urology, Ankara Bilkent City Hospital, Ankara 06800, Cankaya, Türkiye
Author contributions: Demirtas G collected and analyzed the patients’ clinical data; Ekberli G wrote and revised the paper; Tiryaki HT conceived and designed the study.
Institutional review board statement: This study was approved by the Ethics Committee of the Ankara Bilkent City Hospital Ethic Committee (No. 1-25-1508).
Informed consent statement: Each patient or patient’s relative was asked to read the informed consent form and provide subsequent formal approval.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: The anonymized dataset can be obtained upon resasonable request from the corresponding author, Gunay Ekberli at gnyekbrl@yahoo.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gunay Ekberli, MD, Associate Professor, Department of Pediatric Urology, Ankara Bilkent City Hospital, Üniversiteler Cad. Bilkent Şehir Hastanesi, Ankara 06800, Cankaya, Türkiye. gnyekbrl@yahoo.com
Received: October 14, 2025 Revised: October 24, 2025 Accepted: November 20, 2025 Published online: January 27, 2026 Processing time: 104 Days and 0.4 Hours
Abstract
BACKGROUND
Surgery for Hirschsprung’s disease (HD) generally results in a satisfactory outcome, but some patients continue to have bowel dysfunction. There are very few studies in the literature that compare the early and late clinical outcomes.
AIM
To evaluate changes in anorectal function and clinical outcome with age in patients who underwent Duhamel operation (DO) for HD.
METHODS
Twenty-eight patients who had previously undergone DO to treat HD were invited to an outpatient clinic upon reaching adulthood to participate in follow-ups. The patients’ clinical data from the early and mid-term follow-ups were evaluated retrospectively based upon the hospital records and datasets from previous studies. The functional outcome tests in adulthood included anorectal manometry, rectoanal inhibitory reflex, maximum anal resting pressure, and a questionnaire.
RESULTS
Among the patients that reached adulthood and underwent early and mid-term evaluations, only 10 responded to the invitation and attended. That study population was comprised of 8 males and 2 females, ranging in age from 19 years to 25 years, with an average of 21.57 years. The anorectal inhibitory reflex was abnormal in 6 of the patients (66.7%). While the rate of patients who were deemed clinically “good” at the early postoperative evaluation was 53%, that rate reached to 90% in the adult evaluation.
CONCLUSION
Improvement correlated with age, while other anorectal manometric parameters were unchanged. Long-term adult follow-up is essential for objectively evaluating surgical outcomes and overall success.
Core Tip: Long-term clinical improvement after the Duhamel operation for Hirschsprung’s disease is dependent on age. Improvement occurs despite persistent manometric abnormalities. We recommend continued adult follow-up for objective outcome assessment.
