Objective: The aim of this study was to evaluate the long term quality of life among adults who had undergone heart-shaped anastomosis for Hirschsprung's disease (HD) during childhood. Methods: Ninety-two cases with HD who had undergone heart-shaped anastomosis between January 1986 and January 1995 were investigated, and 90 adults with pediatric surgical and gastrointestinal disorders during the same period were randomly collected to serve as controls. They were to complete bowel function score (BFS) and WHO Quality of Life-BREF (QLB). Results: In BFS, there was significant difference in soiling between the HD group and the control group. Eight patients presented occasional soiling, with six of them having undergone two or more operations. Comparing persons without soiling in the HD group and controls, no significant difference was found in each area of QLB, and there was significant difference in psychology and low quality of life subjective feelings in the soiling group compared with the other HD persons and controls, respectively. Conclusion: The long-term outcome of heart-shaped anastomosis for Hirschsprung's disease is satisfying. Recurrent operation is a high risk for soiling occurrence. It should be emphasized to remove all the lesion segment in the first operation. (c) 2015 Elsevier Inc. All rights reserved.