WOFAPS 2025 8th World Congress of Pediatric Surgery

Hai-Bo Huang ¹, Hua Xie ², Chunyi Ji ³, Yujie Lu ⁴, Weibing Tang ², Qiang Yin ³, Mei Yu ⁴, Olivia Monteiro ¹, Paul Kwong-Hang Tam ¹

¹ Macau University of Science and Technology
² Nanjing Children's Hospital
³ Hunan Children's Hospitall
⁴ Maternal and Child Health Hospital of Guiyang City

Objective: To evaluate the school functioning (SF), peer relationships and bowel function outcomes of patients after corrective surgery for Hirschsprung disease(HSCR) in comparison to healthy controls. Methods: This study is prospectively designed using a cellphone-based self-report survey from October 1, 2024 through May 31, 2025, in three tertiary surgical centers in China. The survey used the SF element of the PedsQL 4.0 Generic Core Scales, the Delaware Bullying Victimization Scale-Student Chinese Revision and the Rintala Bowel Function Scale. These scales were independently rated by participants during investigators’ cellphone calls and collated to a composite score of all dimensions. Propensity score matching (PSM) was performed for age, sex, demographic factors and socioeconomic background of families. Results: A total of 735 valid surveys were completed in this study, including 323 patients with HSCR and 412 healthy controls. The median (IQR) age was 9 (8-10) years, with 531 male (72%) and 688 (94%) participants in primary school. Significant differences were observed in age, male sex, parents’ education levels, parents’ income, and mother’s occupation status before PSM. Stratified 1:1 matching yielded 207 HSCR cases and 207 controls with no statistical difference between two groups regarding all parameters. HSCR children performed significantly worse in Mathematics compared to control (41.1% vs. 54.6% obtaining Grade A, P=0.006), but there are no differences in performance in Chinese language. More students with HSCR experienced abnormal bowel function (27.1% vs. 0%, P<0.001), particularly fecal soiling (56.0% vs 0%), fecal accidents (23.7% vs 0%) and bowel-associated social problems (9.2% vs 2.9%). The overall SF scores in the HSCR group was lower than those in controls [Median (IQR) 95 (85-100) vs. 100 (90-100), respectively, P<0.001], due to more incidences of attention issues and memory problems. Interestingly, there was no difference in the incidence of bullying in HSCR patients when compared to controls (30.0% vs.25.6%, P=0.323). Conclusions: Students with HSCR had lower bowel function and school function scores. Students with HSCR were less likely to achieve high scores in mathematics, while their performance in Chinese language remained comparable to that of their peers. This may reflect challenges in sustaining attention for subjects like mathematics. However, their basic academic competence is intact, suggesting that they may benefit from targeted academic support from their schools.