Quality of life after gastric transposition for oesophageal atresia.

Background/purpose: A small proportion of infants born with oesophageal atresia in which the gap between the 2 ends of the oesophagus is too great for an end-to-end anastomosis will require oesophageal replacement. Since 1981 the author's procedure of choice for oesophageal replacement has been gastric transposition. The long-term functional outcome appears to be satisfactory, but the quality of life of these patients has not been investigated formally.

Hirschsprung's disease: functional and psychological follow up comparing total colonic and rectosigmoid aganglionosis.

Aims: To compare the long term functional and psychosocial outcomes following surgical treatment for total colonic aganglionosis (TCA) with those in an age and gender matched group of patients with rectosigmoid aganglionosis (RSA).

Methods: Fifteen patients with TCA matched for age and gender with 15 patients with RSA were studied 7-17 years after the definitive operation. The internal and external sphincters were examined using anal endosonography.

Educational attainments in early adolescence of infants who required major neonatal surgery.

Purpose: The aim of this study was to assess long-term educational attainment in adolescence of former infants who required major neonatal surgery.

Methods: The study is an extension of a prospective longitudinal study begun in 1983 on 30 full-term newborns requiring major neonatal surgery, a matched healthy control group, and full-term infants requiring neonatal intensive care for medical reasons. Educational attainment levels were obtained from the results of compulsory national curriculum examinations taken at age 11 years in 3 core academic subjects, English, Mathematics, and Science and teachers' assessments of current academic performance.

Coping strategies of children with faecal incontinence.

As part of a study concerning the psychosocial adjustment of 160 children treated for anorectal anomalies, the authors investigated the ways in which the children coped with faecal incontinence (FIC). At the time of assessment, the children were 6 to 18 years of age. Portions of the in-depth interviews with the children and their parents covered questions about methods of managing and coping with FIC at home, socially, and at school.

Psychosocial adjustment of children treated for anorectal anomalies.

The psychosocial adjustment of 160 children with anorectal malformations was assessed at 6 to 17 years of age in relation to levels of continence (Kelly score). Five measures of emotional and behavioural adjustment were used to assess a number of domains of child/adolescent functioning and to include measures from multiple perspectives. The psychiatric assessment of the child identified a disorder in 29% of the group overall.

Social and emotional impact of faecal incontinence after surgery for anorectal abnormalities.

A significant proportion of children with anorectal malformations have long term problems with faecal continence. The psychological consequences of this chronic disability was assessed in 160 children and adolescents. The prevalence of clinically significant emotional problems among the sample overall, as assessed by a diagnostic psychiatric interview (19%), parental assessment (27%), and child self report depressive scale (24%) was higher than expected relative to normative populations.

Intellectual development at 3 years of age of children who underwent major neonatal surgery.

Thirty full-term infants born with surgically correctable life-threatening abnormalities who underwent emergency neonatal surgery were followed up from birth to 3 years of age. Comparable data were obtained on a matched group of healthy newborn babies. At 3 years the cognitive functioning of children whose condition had been resolved in the early months of life was similar to the controls.

Effects of early hospitalization and surgery on the emotional development of 3 year olds: An exploratory study.

The emotional and social development of full term infants who required major neonatal surgery were compared prospectively over 3 years with those of a matched group of healthy infants. Ratings of the mother-child relationship and attachment ratings at 12 months indicated that in the short-term there was no evidence of any adverse effects of early hospitalization. At 3 years of age however, the children in the surgical group as a whole showed an increased incidence of behaviour problems, and there was a higher rate of difficulties in the mother-child relationship compared with the controls.

Developmental progress of newborns undergoing neonatal surgery.

The development of 30 full-term infants undergoing surgery soon after birth was compared with a matched group of 29 healthy newborn infants in a prospective longitudinal study. At 1 year of age the infants who underwent surgery were performing within the normal range, but significantly less well than the controls in almost all areas of development. Of the various neonatal and perinatal factors studied, the length of hospital admission was the one most strongly associated with developmental progress at 1 year of age.

Factors associated with developmental progress of full term neonates who required intensive care.

The development of 43 infants born at full term, who were admitted to neonatal intensive care units shortly after birth, was compared in a prospective longitudinal study with that of a group of 29 healthy newborn babies. Thirty infants required emergency operations during the neonatal period, and 13 were admitted for medical reasons. The effects of being in hospital and being separated from their mothers were also studied.