Laparoscopic Duhamel Pullthrough Procedure for Hirschsprung's Disease in Childhood

Smith, Baird M.; Steiner, Rodney; Lobe, Thom E.

doi:10.1089/lps.1994.4.273

Cited by 86 publications

(39 citation statements)

References 2 publications

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“…HAC during defecation occurred in five of six cases (83.3%) (Figs. 2,3,4). In the remaining one case, moderate amplitude contraction occurred during defecation.…”

Section: Results Of Colonic Manometry On Defecationmentioning

confidence: 91%

Is high amplitude propagated contraction present after transanal endorectal pull-through for Hirschsprung’s disease?

et al. 2007

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The transanal endorectal pull-through (TAEPT) procedure is now widely performed for Hirschsprung's disease (HD), however, the colorectal function after TAEPT has not yet been adequately assessed. We evaluated the postoperative clinical outcome and colorectal function based on lower colonic manometry after TAEPT. Twenty-one cases of HD underwent TAEPT from 1998 to 2005. We examined the clinical outcome based on the requirement of enemas/suppositories, the number of defecations per day, the severity of perianal erosion, and the incidence of enterocolitis requiring hospital stay. Using a three-channel Dentsleeve catheter and UPS-2020 measuring device, we performed postoperative colonic manometry at three locations: (1) the anal canal, (2) 5 cm proximal to the anal canal, and (3) 10 cm proximal to the anal canal, during defecation, and then we measured the appearance of high-amplitude contraction (HAC) (duration >/=10 s, amplitude >/=100 cmH(2)O). Four of 21 cases were treated with enemas/suppositories no longer than 1 year. The number of defecations decreased gradually from 4 to 5 per day in the early postoperative period, reaching 2 to 3 per day about 1 year postoperatively. Perianal erosion was noted in 3 of 21 cases but it disappeared within three postoperative years. Two cases had enterocolitis. Lower colon manometry was performed in eight cases. Manometry during defecation was successfully monitored in six cases. HAC occurred in five of six cases (83.3%). The clinical outcomes after TAEPT were satisfactory in almost all cases. These good outcomes were possibly due to the occurrence of HAC during defecation, though HAC did not fill the definition of high amplitude propagated contractions (HAPCs). The occurrence of HAC after TAEPT might be caused by keeping any damage to the mesenteric ascending cholinergic nerve to a minimum during surgery. Further long-term observations are still required to make an adequate assessment of such cases.

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“…HAC during defecation occurred in five of six cases (83.3%) (Figs. 2,3,4). In the remaining one case, moderate amplitude contraction occurred during defecation.…”

Section: Results Of Colonic Manometry On Defecationmentioning

confidence: 91%

Is high amplitude propagated contraction present after transanal endorectal pull-through for Hirschsprung’s disease?

et al. 2007

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“…The HD was first described in 1886, since than many procedures has been described for its management [1][2][3][4][5][6][7][8]. In recent years laparoscopy has evolved in the management of HD from extramucosal biopsy to primary definitive management [3].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years laparoscopy has evolved in the management of HD from extramucosal biopsy to primary definitive management [3]. In 1994, Smith et al reported the first successful laparoscopic Duhamel pull-through [8]. In 1995, Georgeson first described the primary laparoscopic pull-through for HD [1].…”

Section: Discussionmentioning

confidence: 99%

“…However, a frozen section is not readily available at our center, thus we staged the procedure in all patients [4,8] Further, in our opinion the efficacy of staged Duhamel procedure is much better in our scenario, because most of the neonates referred late to us with low general condition, enterocolitis or colonic perforations where decompressing colostomy is life saving [13] in first stage multiple seromuscular biopsies was done via open methods and biopsy site was marked by fine nonabsorbable sutures for preoperative identification in next stage. All these procedures were done in emergency operation theatre by senior residents.…”

Section: Discussionmentioning

confidence: 99%

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" The Laparoscopic Assisted Duhamel Pull through Procedure for Hirschsprung’s Disease: Our Technique and Short Term Results "

Singh

Wakhlu

Srivastava

et al. 2017

JPNC

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Aims: To prospectively evaluate the laparoscopic assisted Duhamel pull through (LADPT) procedure for Hirschsprung's disease at our centre. Material and methods:After clinico-radiological diagnosis of Hirschsprung's disease junctional colostomy and mutltiple seromuscular biopsy was taken. After histological confirmation of diagnosis definitive surgery was done by laparoscopic assisted Duhamal procedure. Mobilization of aganglionic bawel and colon proximal to leveling colostomy was done laproscopically. The leveling colostomy taken down, bowel divided at the ganglionic segment, proximal colon pulled into retro-rectal avascular tunnel, all through the colostomy incision. Transanal stapled side to side colo-rectal anastomosis was done with rectal stump closure. Results: Mean age of surgery was 6.0±0.23 months comparable in both groups (ranged 3 m-5 yrs). Mean operative time, blood loss and hospital stay with range were 80±0.30 (70-100 minutes), 50±0.20 (40-90 ml) and 6±0.21 (3-12 days) less in LADPT cases compared with open Duhamel (p value .008, 0.0067 and .009 respectively). Per-operative one left ureteric injury occurred in LADPT. In one year of follow-up revision LADPT (for neuronal intestinal dysplasia) and reexploration due to small bowel stricture were needed in one patient each, there was one death due to fulminant enterocolitis. Conclusions:In terms of ease of mobilization of the rectum and sigmoid colon, hemostasis, shorter operative time, less analgesic requirement, early postoperative recovery and small abdominal scar LADPT is a feasible procedure for Hirschsprung's Disease with a junctional colostomy.

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“…(Smith et al, 1994;Curran & Raffensperger, 1996;Rothenberg & Chang, 1997;Morikawa et al, 1998;Hirose et al, 1999;De Lagausie, 1999;Moog et al, 2001;Polliotto et al, 2001;Bonnard et al, 2001;Falchetti et al, 2003;Shah & Shah, 2003;Georgeson, 2004;Antao & Roberts, 2005;Lien & Hau, 2006;Craigie et al, 2007).…”

Section: Abaixamento Colônico Em Um Tempo Cirúrgicounclassified

Abaixamento endoanal do colón no tratamento da moléstia de Hirschsprung

Takegawa¹

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Laparoscopic Duhamel Pullthrough Procedure for Hirschsprung's Disease in Childhood

Cited by 86 publications

References 2 publications

Is high amplitude propagated contraction present after transanal endorectal pull-through for Hirschsprung’s disease?

Is high amplitude propagated contraction present after transanal endorectal pull-through for Hirschsprung’s disease?

" The Laparoscopic Assisted Duhamel Pull through Procedure for Hirschsprung’s Disease: Our Technique and Short Term Results "

Abaixamento endoanal do colón no tratamento da moléstia de Hirschsprung

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