{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T05:39:07Z","timestamp":1792733947170,"version":"4.5.0"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003Late diagnosis of Hirschsprung's disease (LDHD) may carry a poor prognosis. Its definition remains unclear and its implication on HD-related core outcomes has not been fully reported.<\/jats:p><jats:p>\n          Methods\u2003A single-center 20-year series was reviewed to include HD with follow-up of 1 year or more post pull-through (PT) and aged 5 years or older. We investigated six core outcomes derived from NETS1HD study by comparing the groups dichotomized by four time points using age at diagnosis (44-week gestation, 6 months, 1 year, and 3 years). Following establishment of definition of LDHD, the outcomes and complications were compared with timely diagnosis of HD (TDHD).<\/jats:p><jats:p>\n          Results\u2003Forty-nine out of eighty-six HD were included. The definition of LDHD was found to be HD diagnosed at 1 year of age or later because 3\/6 core outcomes were significantly worse than TDHD. Nine patients (18%) had LDHD\u2014median age at diagnosis 42 months (12\u201389) and PT performed at 57 months (12\u2013103), mostly Soave (73%); a covering stoma was performed in 7\/9, significantly higher than TDHD in 10\/40 (p\u2009=\u20090.001). LDHD was associated with increased unplanned surgery (78% vs. 30%, p\u2009=\u20090.019), fecal incontinence (100% vs. 62%, p\u2009=\u20090.01), and permanent stoma (33% vs. 5%, p\u2009=\u20090.037). Major complications (56% vs. 20%, p\u2009=\u20090.043) and redo PT (33% vs. 5%, p\u2009=\u20090.037) were also higher in LDHD.<\/jats:p><jats:p>\n          Conclusion\u2003LDHD could be defined as HD diagnosis at or over 1 year of age. LDHD was associated with more preoperative stoma, major postoperative complications, unplanned reoperation, and worse HD-related core outcomes.<\/jats:p>","DOI":"10.1055\/s-0042-1744147","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T23:47:02Z","timestamp":1646869622000},"page":"512-520","source":"Crossref","is-referenced-by-count":17,"title":["Late Diagnosis of Hirschsprung's Disease: Definition and Implication on Core Outcomes"],"prefix":"10.1055","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5878-0471","authenticated-orcid":false,"given":"Yew-Wei","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Chelsea and Westminster Hospital, Chelsea, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Sofia","family":"Chacon","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Chelsea and Westminster Hospital, Chelsea, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niamh","family":"Geoghegan","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Chelsea and Westminster Hospital, Chelsea, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amulya","family":"Saxena","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Chelsea and Westminster Hospital, Chelsea, London, United Kingdom"},{"name":"Department of Paediatric Surgery, Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Clarke","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Chelsea and Westminster Hospital, Chelsea, London, United Kingdom"},{"name":"Department of Paediatric Surgery, Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munther","family":"Haddad","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Chelsea and Westminster Hospital, Chelsea, London, United Kingdom"},{"name":"Department of Paediatric Surgery, Imperial College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Choudhry","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Chelsea and Westminster Hospital, Chelsea, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,3,9]]},"reference":[{"key":"ref1","first-page":"722","article-title":"British Association of Paediatric Surgeons congenital anomalies surveillance system","volume":"102","author":"T J Bradnock","year":"2017","journal-title":"Arch Dis Child"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1136\/archdischild-2017-312901","article-title":"NETS1HD study: development of a Hirschsprung's disease core outcome set","volume":"102","author":"B SR Allin","year":"2017","journal-title":"Arch Dis Child"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1097\/MOP.0000000000000345","article-title":"Surgical options for the management of severe functional constipation in children","volume":"28","author":"R J Wood","year":"2016","journal-title":"Curr Opin Pediatr"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"82","DOI":"10.4103\/0189-6725.182562","article-title":"How to manage a late diagnosed Hirschsprung's disease","volume":"13","author":"M Ouladsaiad","year":"2016","journal-title":"Afr J Paediatr Surg"},{"issue":"10","key":"ref6","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1016\/j.jpedsurg.2012.04.022","article-title":"Late diagnosis of Hirschsprung disease\u2013patient characteristics and results","volume":"47","author":"K J Stensrud","year":"2012","journal-title":"J Pediatr Surg"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.pedneo.2012.01.011","article-title":"Clinical impacts of delayed diagnosis of Hirschsprung's disease in newborn infants","volume":"53","author":"C C Lee","year":"2012","journal-title":"Pediatr Neonatol"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"D Dindo","year":"2004","journal-title":"Ann Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1136\/archdischild-2020-320310","article-title":"Outcomes at five to eight years of age for children with Hirschsprung's disease","volume":"106","author":"B SR Allin","year":"2020","journal-title":"Arch Dis Child"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1136\/adc.39.204.116","article-title":"Hirschsprung's disease: a new surgical technique","volume":"39","author":"F Soave","year":"1964","journal-title":"Arch Dis Child"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1136\/adc.35.179.38","article-title":"A new operation for the treatment of Hirschsprung's disease","volume":"35","author":"B Duhamel","year":"1960","journal-title":"Arch Dis Child"},{"issue":"15","key":"ref12","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1056\/NEJM195510132531502","article-title":"Rectal biopsy as an aid in the diagnosis of Hirschsprung's disease","volume":"253","author":"O Swenson","year":"1955","journal-title":"N Engl J Med"},{"issue":"02","key":"ref13","first-page":"212","article-title":"Resection of rectum and rectosigmoid with preservation of the sphincter for benign spastic lesions producing megacolon; an experimental study","volume":"24","author":"O Swenson","year":"1948","journal-title":"Surgery"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s00383-011-3002-5","article-title":"Hirschsprung's disease presenting beyond infancy: surgical options and postoperative outcome","volume":"28","author":"S Sharma","year":"2012","journal-title":"Pediatr Surg Int"},{"issue":"09","key":"ref15","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1016\/j.jpedsurg.2017.05.008","article-title":"The use of stomas in the early management of Hirschsprung disease: findings of a national, prospective cohort study","volume":"52","author":"T J Bradnock","year":"2017","journal-title":"J Pediatr Surg"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.jpedsurg.2019.06.013","article-title":"Primary laparoscopic endorectal pull-through procedure with or without a postoperative rectal tube for Hirschsprung disease: a multicenter perspective study","volume":"55","author":"X Zhang","year":"2020","journal-title":"J Pediatr Surg"},{"issue":"25","key":"ref17","doi-asserted-by":"crossref","first-page":"3268","DOI":"10.3748\/wjg.v25.i25.3268","article-title":"Botulinum toxin injections after surgery for Hirschsprung disease: systematic review and meta-analysis","volume":"25","author":"D Roorda","year":"2019","journal-title":"World J Gastroenterol"},{"issue":"S 01","key":"ref18","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1007\/s12262-012-0519-3","article-title":"Management of recurrent post redo pull-through stricture - what is the option?","volume":"75","author":"S Khope","year":"2013","journal-title":"Indian J Surg"},{"issue":"07","key":"ref19","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1016\/S0022-3468(99)90585-7","article-title":"Repeat pull-through surgery for complicated Hirschsprung's disease: indications, techniques, and results","volume":"34","author":"J C Langer","year":"1999","journal-title":"J Pediatr Surg"},{"issue":"09","key":"ref20","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1007\/s00383-015-3742-8","article-title":"Rectal suction biopsy for the diagnosis of Hirschsprung's disease: a systematic review of diagnostic accuracy and complications","volume":"31","author":"F Friedmacher","year":"2015","journal-title":"Pediatr Surg Int"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1722858","article-title":"A critical analysis of rectal biopsy to exclude Hirschsprung's disease","author":"Y W Tan","year":"2021","journal-title":"Eur J Pediatr Surg"}],"container-title":["European Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1744147.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:59:22Z","timestamp":1668560362000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1744147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,9]]},"references-count":20,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2022,11,15]]},"published-print":{"date-parts":[[2022,12]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1744147","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0939-7248","1439-359X"],"issn-type":[{"value":"0939-7248","type":"print"},{"value":"1439-359X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,9]]}}}