Single-stage transanal endorectal pull-through procedure for correction of Hirschsprung disease in neonates and nonneonates: A multicenter study

Lu, Changgui; Hou, Guangjun; Liu, Chunyi; Qian, Geng; Xu, Xiaoqun; Zhang, Jie; Chen, Huan; Tang, Weibing

doi:10.1016/j.jpedsurg.2017.01.061

Cited by 45 publications

(28 citation statements)

References 40 publications

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“…Both groups showed majority of gender was male as reported male/female compassion: neonatal group (120/66) and non-neonatal group (377/87). 8 In this study the mean of bowel resection was 18.64 cm range from 7-25 cm. A prospective study by Abdul-Ghafoor et al showed the average length of the resected aganglionic segment was (13.9 cm) ranging from (9 -25 cm).…”

Section: Discussionmentioning

confidence: 59%

Transanal endorectal pull-through in children as the treatment for Hirschsprung’sd in Aceh, Indonesia

Isa¹,

Syahputra²,

Hutagalung³

2019

Int Surg J

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Background: One-stage pull-through operation has become increasingly popular for the treatment of Hirschsprung's disease. The advantages of total transanal pull-through include minimal resection of the dilated ganglionic part of the colon, shorter hospital stay, decreased total cost, lower risk of adhesive intestinal obstruction.Methods: A retrospective study of patients with HD underwent transanal endorectal pull-through (TERPT) procedure treated at Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia between January 2010 – December 2013. We assessed patients characteristic, outcome and complication including Hirsch sprung associated enterocolitis (HAEC).Results: A total 77 patients were included in this study. The mean age was 13.01 months (range from 11 days – 8 years old). Most of the patients (55.8%) were male and female (44.2%). Clinical classification of HD: short segment 74 patients (96.1%) and ultra-short segment 3 patients (3.9%). The mean of bowel resection length in TERPT procedure was 18.64 cm (range from 7–25 cm). There is no mortality associated with TERPT procedure. Hirsch sprung associated enterocolitis (HAEC) occurred in 43 subjects (54.5%). Statistical analysis showed the significant relation between age at surgery and HAEC (p= 0.000) and no significant relationship between gender (p=0.425) and bowel resection length (p=0.780) with HAEC.Conclusions: Transanal endorectal pull-through procedure has been shown as an effective minimally invasive treatment in resolving obstructive symptoms in ultra–short segment of HD patients. The number of HAEC incidence among HD patients underwent TERPT significantly increased with older age of children.

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Section: Discussionmentioning

confidence: 59%

Transanal endorectal pull-through in children as the treatment for Hirschsprung’sd in Aceh, Indonesia

Isa¹,

Syahputra²,

Hutagalung³

2019

Int Surg J

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“…In this study, no cases of anastomotic leakage or remaining aganglionic segment were reported, however these complications have been reported in other studies although the rate of these complication was low. 4,8,12,16 The 3-month follow-up complication rate was 24.25%, mainly enterocolitis which was similar to the TOSEPT alone approach. 12,16 There was no statistically significant difference between additional open and laparoscopic procedure (Table 4).…”

Section: Discussionmentioning

confidence: 71%

Impact of additional abdominal approach to transanal one stage endorectal pull-through in treatment of Hirschsprung’s disease

Thien¹,

Thanh²,

Xuan³

et al. 2019

Int Surg J

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Background: The transanal one-stage endorectal pull-through (TOSEPT) procedure sometimes requires assistance by an abdominal approach to complete the operation. This study aims to rectify this by evaluating the impact of an assisted abdominal approach in the outcomes of the TOSEPT in children with HD.Methods: A retrospective study was conducted at surgical paediatric department of Hue central hospital. All consecutive medical records of patients operated on for HD in our department between June 2010 and June 2018 were retrieved and analysed.Results: 66/446 (14.79%) patients with HD who required TOSEPT with an additional abdominal approach to complete the operation for inclusion in this retrospective study. Length of the resected colon: 13.30±3.45 cm (open group) and 19.70±4.50 cm (laparoscopic group). Average operative time: 156±12 minutes (open group) and 170±14 minutes (laparoscopic group). No deaths or intra-operative complications were recorded in this study. No postoperative complication occured in the laparoscopic group. Grade II complication based on Dindo-Clavien classification occurred in 14 (21.21%) of the open group and one (1.51%) grade III complication. The length of hospital stay was shorter in the laparoscopic group at 5±1.5 days compared to 7±2.5 days for the open group. All of the complications were grade I or II, mainly enterocolitis at 3-month follow-up.Conclusions: Additional abdominal approach impacts on post-operative results of TOSEPT procedure for HD but not on outcome of disease. Laparoscopic surgery as the additional abdominal approach should be used to reduce the complications.

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“…7,9 Reported enterocolitis rates vary greatly from 10 to 44% depending on definitions used. [3][4][5][6][7][8][9]21 Most patients experience one or two episode and respond well to oral metronidazole, while prevalence of enterocolitis episodes decreases with increasing age. 5,13 Recurrent enterocolitis, especially when associated with obstructive symptoms, should be addressed in detail as discussed above.…”

Section: Anastomotic Leakage and Stricturesmentioning

confidence: 99%

“…1,2 Today, pull-through is commonly performed during the neonatal period or early infancy soon after the diagnosis is confirmed. [3][4][5][6] Transanal pull-through includes variable surgical elements, which have undergone technical modifications during the last decades. Colonic mobilization and biopsies are often performed laparoscopically or through an umbilical mini-incision instead of conventional laparotomy, while other surgeons perform the entire operation and frozen section biopsies transanally.…”

Section: Introductionmentioning

confidence: 99%

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Perioperative Complications of Transanal Pull-through Surgery for Hirschsprung's Disease

Pakarinen

2018

Eur J Pediatr Surg

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Transanal pull-through is currently one of the most commonly used operation to treat Hirschsprung's disease (HD) worldwide. It has undergone some technical modifications during the last decades and still contains variable surgical practices. As high quality comparative studies between different surgical approaches are missing, debate over the optimal operation for HD still continues. Transanal pull-through is associated with multiple potential complications, which may result in permanently impaired functional outcome, life-long morbidity, and significant social restrictions. Although some of the surgical complications can be successfully managed by repeated surgery, the best changes for optimal bowel function and fecal continence are lost. Surgical complications are best treated by efficient prevention with careful adherence to established surgical techniques and principles during the primary operation.

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Single-stage transanal endorectal pull-through procedure for correction of Hirschsprung disease in neonates and nonneonates: A multicenter study

Cited by 45 publications

References 40 publications

Transanal endorectal pull-through in children as the treatment for Hirschsprung’sd in Aceh, Indonesia

Transanal endorectal pull-through in children as the treatment for Hirschsprung’sd in Aceh, Indonesia

Impact of additional abdominal approach to transanal one stage endorectal pull-through in treatment of Hirschsprung’s disease

Perioperative Complications of Transanal Pull-through Surgery for Hirschsprung's Disease

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