Soave transanal one-stage endorectal pull-through in the treatment of Hirschsprung′s disease of the child above two-year-old: A report of 20 cases

Ksia, Amine; Yengui, H.; Saad, Manel Ben; Sahnoun, Lassâad; Maazoun, K.; Laamiri, R.; Krichène, I.; Mekki, Mongi; Belguith, M.; Nouri, Abdellatif

doi:10.4103/0189-6725.125449

Cited by 11 publications

(4 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is significantly shorter than the average operative time in another study conducted in our department in patients of over 2 years age, who underwent a single-stage Soave endorectal pullthrough (240 minutes). [12] There was no significant intraoperative bleeding. This can be explained by the easier mucosal dissection during the neonatal period due to the presence of less adherent mucosa (no repeated episodes of enterocolitis), a less dilated colon above the aganglionic segment, that the mesentery and the colon are less substantial and easier to mobilize and that the blood vessels are easier to control.…”

Section: Discussionmentioning

confidence: 87%

Transanal pull-through for Hirschsprung disease in neonates: A single-center experience

Kechiche,

Sellami,

Makhlouf

et al. 2023

J Neonatal Surg

View full text Add to dashboard Cite

Background: Transanal pull-through for the treatment of Hirschsprung disease in the neonatal period remains debatable. This study reported our experience with transanal pull-through in neonates. Methods: We reviewed medical records of neonates with Hirschsprung disease treated in our department with transanal pull-through between the years 2010 and 2016. Results: Of the 40 included patients, 31 were male neonates, and 9 were female. The mean age at the time of surgery was 13 days. The mean operative time was 136 minutes. The level of aganglionosis was rectal in 8 cases, rectosigmoid in 19 cases, descending colon in 7 cases, splenic flexure in 3 cases, transverse colon in 2 cases, and ascending colon in one case. A combined abdominal approach was used in 11 patients. There were no intraoperative complications. Major complications were noted in 4 cases: anastomotic leakage in 3 cases of whom one succumbed 3 days postoperatively; and bowel perforation in one case. The most common late postoperative complication was fecal soiling encountered in 25% of cases. Two among 29 patients who reached the age of continence remain incontinent. Conclusion: Transanal pull-through in neonates has similar outcomes and complications to those of infants and children. Therefore this procedure can be safely employed in neonates however we recommend that the treating team should have an ample learning curve for this procedure in infants.

show abstract

Section: Discussionmentioning

confidence: 87%

Transanal pull-through for Hirschsprung disease in neonates: A single-center experience

Kechiche,

Sellami,

Makhlouf

et al. 2023

J Neonatal Surg

View full text Add to dashboard Cite

show abstract

“…Some paediatric surgeons documented that the role of laparoscopy in the interventional surgery for HD is limited to those with long aganglionic segment based on contrast enema study. [ 12 13 ] The reported advantages of laparoscopy for the management of HD cases were in agreement with those reported by Ksia et al .,[ 14 ] who retrospectively studied 20 patients older than 2 years who underwent a transanal Soave one-stage endorectal pull-through procedure for HD and concluded that laparoscopy may be necessary whenever there are difficulties in the pull-through. In our study, we used laparoscopy in short and long aganglionic segments.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic-assisted Transanal Pull-through for Hirschsprung's Children Older than 3 Years

Arafa

Mohamed

Taher

et al. 2021

African Journal of Paediatric Surgery

View full text Add to dashboard Cite

Context: Hirschsprung's disease (HD) is a congenital anomaly affecting the enteric nervous system commonly the rectosigmoid region. Treatment is surgical where the aganglionic segment is resected, and bowel continuity is restored by a coloanal anastomosis. In 1999, Georgeson et al. proposed a new technique of primary laparoscopic-assisted pull-through for HD as a new gold standard. Aim: The aim of the study was to evaluate the outcome of the laparoscopic-aided transanal pull-through procedure for the management of HD in children older than 3 years of age. Methods: This study was conducted on 15 consecutive patients presented to a university hospital, diagnosed as having HD relying on their clinical features, barium enema study and rectal biopsy. In all cases, laparoscopic-assisted transanal pull-through was attempted. The laparoscopic part included transition zone identification, seromuscular biopsy for fresh frozen histopathology and sigmoid and rectal mobilisation as much as possible down the peritoneal reflection. The transanal part included mobilisation of the rectal lower segment by 2–3 cm, resection till the ganglionic segment, and full-thickness two-layer coloanal anastomosis was done. Results: Early complications occurred in eight cases: enterocolitis in four cases and perianal excoriation occurred in four cases. There were no cases of anastomotic leak. Late complications occurred in seven patients: four cases developed stricture at the site of coloanal anastomosis and three cases experienced enterocolitis at 6 and 9 months postoperatively. Conclusion: Laparoscopic-aided transanal pull-through procedure is a safe, feasible modality for the management of HD in children more than 3 years.

show abstract

“…In a study by Ralls et al, redo pull-through patients of HD have worse stooling results than initial operations [ 27 ]. A study analyzed the growth outcomes of patients who underwent different pull-through methods; the Duhamel procedure (DP), Swenson procedure (SP), and TERPT showed the improvement of nutritional status was achieved in 21.2% of HD patients after TERPT, 14.3% post-Duhamel, and 5.9% following the Soave procedure [ 28 ]. In a study by Urushiara et al, it was shown that laparoscopic Z-shaped colorectal anastomosis for HD appears feasible and safe to perform with good results [ 29 ].…”

Section: Reviewmentioning

confidence: 99%

Post-surgical Outcomes of Different Surgical Techniques in Hirschsprung’s Disease: A Literature Review

Munnangi,

Sayed Mushir Ali,

Deva

et al. 2023

Cureus

View full text Add to dashboard Cite

Hirschsprung's disease (HD) is a rare condition that affects newborns and is characterized by the lack of ganglion cells in the colon. Typical symptoms include difficulty passing stool, vomiting, and trouble feeding. Various surgical methods are available to manage the condition. The aim of the study is to investigate and compare the post-surgical outcomes of different surgical techniques used in the treatment of HD. A thorough literature search was conducted using various electronic databases to identify relevant studies to be referred to. Double-blinded screening of the identified articles led to the final selection of 40 out of 440 HD, including transanal endorectal pull-through (TERPT), laparoscopic approaches, and modified techniques. Several studies have investigated surgical procedures for HD, including TERPT, laparoscopic methods, and modified techniques. These have shown positive outcomes, with fewer complications, improved bowel function, and favorable cosmetic results. Individual patient characteristics and surgeon expertise should guide procedure selection. Surgery for HD aims to restore normal bowel function, but post-surgical outcomes can include constipation or fecal incontinence. Complications like enterocolitis, anastomotic stricture, and sphincter damage may occur. Laparoscopic approaches have shorter hospital stays. However long-term follow-up is essential to assess quality of life, psychological well-being, and potential side effects.

show abstract

Soave transanal one-stage endorectal pull-through in the treatment of Hirschsprung′s disease of the child above two-year-old: A report of 20 cases

Abstract: Soave transanal one-stage endorectal pull-through is safely feasible in children of more than two years of age. Laparoscopy may be necessary whenever there are difficulties in the pull-through.

Cited by 11 publications

References 14 publications

Transanal pull-through for Hirschsprung disease in neonates: A single-center experience

Transanal pull-through for Hirschsprung disease in neonates: A single-center experience

Laparoscopic-assisted Transanal Pull-through for Hirschsprung's Children Older than 3 Years

Post-surgical Outcomes of Different Surgical Techniques in Hirschsprung’s Disease: A Literature Review

Contact Info

Product

Resources

About