Introduction:
Hirschsprung’s disease (HD) is a congenital disorder characterized by aganglionosis of the distal bowel. The transanal endorectal pull‑through (TERPT) using the de la Torre modification has emerged as a widely accepted single‑stage technique for short‑segment HD. This study’s aim was to use the standardized scoring systems, Rintala’s bowel function score (RBS) and Krickenbeck consensus classification (KCC), to determine the functional outcomes, quality of life and highlight factors influencing outcomes following TERPT in pediatric HD.

Material and methods:
This cross-sectional study was conducted at a single tertiary care center from January 2022 to December 2025. Fifty consecutive children with “rectosigmoid” (short-segment) HD with histologically confirmed HD who underwent TERPT were included. Functional outcomes were assessed ≥ 1 year postoperatively or at the toilet‑training age using RBS and KCC. Secondary outcomes included postoperative complications, reoperations, and parental‑reported quality of life.

Results:
The study includes 39 males (78%) and 11 females (22%), with a mean age at surgery of 6.3 ±2.5 months. At a mean follow‑up of 5.1 ±1.8 years, the mean RBS was 17.1 ±2.9, with 80% achieving good‑to‑excellent bowel function. According to KCC, 70% had complete continence, while 12% experienced severe soiling and 12% severe constipation. Early complications occurred in 18%, mainly perianal excoriation and Hirschsprung-associated enterocolitis (HAEC). Long‑term complications included HAEC (20%), anastomotic stricture (10%), and cuff abscess (2%). Constipation correlated with stricture (OR 10.5, p = 0.04), and soiling with prior HAEC (p < 0.05).

Conclusions:
Transanal endorectal pull‑through using the de la Torre modification provides favorable long‑term functional outcomes and quality of life in rectosigmoid HD. Despite a minority experiencing constipation or soiling, most children achieve socially acceptable continence, underscoring the importance of ongoing bowel management protocols.