Classification of short-term complications after transanal endorectal pullthrough for Hirschsprung’s disease using the Clavien–Dindo-grading system

Abstract

Purpose: Hirschsprung’s disease (HSCR) is a developmental defect of the enteric nervous system. Transanal endorectal pullthrough (TERPT) is one of the surgical procedures for HSCR. Clavien–Dindo is an objective classification system, used worldwide, to describe postoperative complications. The aim of this study was to use Clavien–Dindo grading for short-term complication after TERPT. Methods: This was a cohort study including all 69 individuals, with biopsy-verified HSCR, managed with TERPT at our institution between 2006 and 2018. Data on the surgical procedure, as well as short-term complications, were retrieved from the medical records. The main outcome was postoperative complications graded according to Clavien–Dindo. Results: Fifteen (22%) of the 69 patients (51 males) had a short-term postoperative complication graded according to Clavien–Dindo. The complications were Grade I in ten patients, Grade II in four patients, and Grade IIIb in one patient. Individuals with a Clavien–Dindo complication had a significantly longer post-operative hospital stay [median 6 days (4–30) compared to 4 days (1–22), p = 0.035]. Conclusions: It is important to describe postoperative complications in a structured way to make it possible to compare studies. Post-operative complications, according to Clavien–Dindo, occurred in 22% of the patients after TERPT.