nach oben

Erschienen in:

05.10.2017 | Original Article

Hirschsprung’s disease in the laparoscopic transanal pull-through era: implications of age at surgery and technical aspects

verfasst von: Go Miyano, Masahiro Takeda, Hiroyuki Koga, Manabu Okawada, Nana Nakazawa-Tanaka, Junya Ishii, Takashi Doi, Geoffrey J. Lane, Tadaharu Okazaki, Masahiko Urao, Atsuyuki Yamataka

Erschienen in: Pediatric Surgery International | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

Aim

Detailed implications of age at laparoscopic transanal pull-through (LTAPT) on postoperative bowel function (POBF) in Hirschsprung’s disease (HD) are somewhat obscure because of a spectrum of factors.

Methods

Age at surgery was used to categorize 106 consecutive postoperative HD cases treated by our modified LTAPT (JLTPAT) between 1997 and 2015; group A: < 3 months old (n = 31); group B: 3–11 months old (n = 44); group C: 1–3 years old (n = 19); and group D: ≥ 4 years old (n = 12). POBF was assessed by reviewing outpatient records 1, 3, 5, 7, and 10 years after JLTAPT prospectively and scoring each of 5 criteria on a scale of 0–2; best score = 10.

Results

Only operative time was statistically longer in group D versus groups A, B, and C. Differences in gender ratios, blood loss, duration of follow-up, and POBF scores were not statistically significant. Mean POBF scores over time were: group A: 6.8, 7.6, 8.4, 8.6, and 8.4; group B: 7.1, 7.8, 8.3, 8.5, and 9.0; group C: 6.9, 7.9, 8.1, 8.3, and 8.6; group D: 7.0, 7.4, 8.2, 8.1, and 8.5, respectively.

Conclusion

Age at JLTAPT was not correlated with POBF in HD.

Teitelbaum DH, Cilley RE, Sherman NJ, Bliss D, Uitvlugt ND, Renaud EJ et al (2000) A decade of experience with the primary pull-through for Hirschsprung disease in the newborn period: a multicenter analysis of outcomes. Ann Surg 232(3):372–380CrossRefPubMedPubMedCentral

Vu PA, Thien HH, Hiep PN (2010) Transanal one-stage endorectal pull-through for Hirschsprung disease: experience with 51 newborn patients. Pediatr Surg Int 26(6):589–592CrossRefPubMed

Pratap A, Gupta DK, Shakya VC, Adhikary S, Tiwari A, Shrestha P et al (2007) Analysis of problems, complications, avoidance and management with transanal pull-through for Hirschsprung disease. J Pediatr Surg 42(11):1869–1876CrossRefPubMed

Haricharan RN, Seo JM, Kelly DR, Mroczek-Musuiman EC, Aprahamian CJ, Morgan TL et al (2008) Older age at diagnosis of Hirschsprung disease decreases risk of postoperative enterocolitis, but resection of additional ganglionated bowel does not. J Pediatr Surg 43(6):1115–1123CrossRefPubMed

Catto-Smith AG, Trajanovska M, Taylor RG (2007) Long-term continence after surgery for Hirschsprung’s disease. J Gastroenterol Hepatol 22(12):2273–2282CrossRefPubMed

Engum SA, Grosfeld JL (2004) Long-term results of treatment of Hirschsprung’s disease. Semin Pediatr Surg 13(4):273–285CrossRefPubMed

Fujiwara N, Kaneyama K, Okazaki T, Lane GJ, Kato Y, Kobayashi H et al (2007) A comparison study of laparoscopy-assisted pull-through and open pull-through for Hirschsprung’s disease with special reference to postoperative fecal continence. J Pediatr Surg 42(12):2071–2074CrossRefPubMed

Fenger C (1979) The anal transitional zone. Location and extent. Acta Pathol Microbiol Scand A 87(5):379–386

Netter FH (2014) Atlas of human anatomy. Including student consult interactive ancillaries and guides. Rectum, 6th edn. Elsevier, Plate, p. 370

10.

El-Sawaf M, Siddiqui S, Mahmoud M, Drongowski R, Teitelbaum DH (2013) Probiotic prophylaxis after pull through for Hirschsprung disease to reduce incidence of enterocolitis: a prospective, randomized, double-blind, placebo-controlled, multicenter trial. J Pediatr Surg 48(1):111–117CrossRefPubMed

11.

Yamataka A, Kaneyama K, Fujiwara N, Hayashi Y, Lane GJ, Kawashima K et al (2009) Rectal mucosal dissection during transanal pull-through for Hirschsprung disease: the anorectal line or the dentate line? J Pediatr Surg 44(1):266–269CrossRefPubMed

12.

Neuvonen MI, Kyrklund K, Rintala RJ, Pakarinen MP (2016) Bowel function and quality of life after transanal endorectal pull-through for Hirschsprung disease: controlled outcomes up to adulthood. Ann Surg (Epub ahead of print)

13.

Miyano G, Koga H, Okawada M, Doi T, Sueyoshi R, Nakamura H et al (2015) Rectal mucosal dissection commencing directly on the anorectal line versus commencing above the dentate line in laparoscopy-assisted transanal pull-through for Hirschsprung’s disease: prospective medium-term follow-up. J Pediatr Surg 50(12):2041–2043CrossRefPubMed

14.

Takahashi T, Kato Y, Okazaki T, Koga H, Lane GJ, Yamataka A (2013) Patchy innervation confirmed in pull-through bowel with normal conventional biopsy results in Hirschsprung’s disease—the benefit of circumferential biopsying. Hepatogastroenterology 60(125):1014–1017PubMed

15.

White FV, Langer JC (2000) Circumferential distribution of ganglion cells in the transition zone of children with Hirschsprung disease. Pediatr Dev Pathol 3(3):216–222CrossRefPubMed

16.

Zani A, Eaton S, Morini F, Puri P, Rintala R, Heurn EV et al (2017) European pediatric surgeon’s association survey on the management of Hirschsprung disease. Eur J Pediatr Surg 27(1):96–101CrossRefPubMed

17.

Keckler SJ, Yang JC, Fraser JD, Aguayo P, Ostlie DJ, Holcomb GW 3rd, et al (2009) Contemporary practice patterns in the surgical management of Hirschsprung’s disease. J Pediatr Surg 44(6):1257–1260CrossRefPubMed

18.

Singh SJ, Croaker GD, Manglick P, Wong CL, Athanasakos H, Elliott E et al (2003) Hirschsprung’s disease: the Australian paediatric surveillance unit’s experience. Pediatr Surg Int 19(4):247–250CrossRefPubMed

19.

Bradnock TJ, Walker GM (2011) Evolution in the management of Hirschsprung’s disease in the UK and Ireland: a national survey of practice revisited. Ann R Coll Surg Engl 93(1):34–38CrossRefPubMed

20.

Huang B, Li WM, Feng ZY, Huang LY (2012) Outcomes and defecation after one-stage transanal endorectal pull-through procedure for Hirschsprung disease. Zhonghua Wei Chang Wai Ke Za Zhi 15(7):715–718PubMed

21.

Lu C, Hou G, Liu C, Geng Q, Xu X, Zhang J et al (2017) Single-stage transanal endorectal pull-through procedure for correction of Hirschsprung disease in neonates and non neonates: a multicenter study. J Pediatr Surg (Epub ahead of print)

22.

Neuvonen MI, Kyrklund K, Lindahi HG, Koivusalo AI, Rintala RJ, Pakarinen MP (2015) A population-based, complete follow-up of 146 consecutive patients after transanal mucosectomy for Hirschsprung disease. J Pediatr Surg 50(10):1653–1658CrossRefPubMed

23.

Hackam DJ, Filler RM, Pearl RH (1998) Enterocolitis after the surgical treatment of Hirschsprung’s disease: risk factors and financial impact. J Pediatr Surg 33(6):830–833CrossRefPubMed

24.

Dickie BH, Webb KM, Eradi B, Levitt MA (2014) The problematic Soave cuff in Hirschsprung disease: manifestations and management. J Pediatr Surg 49(1):77–80CrossRefPubMed

25.

Friedmacher F, Puri P (2011) Residual aganglionosis after pull-through operation for Hirschsprung’s disease: a systematic review and meta-analysis. Pediatr Surg Int 27(10):1053–1057CrossRefPubMed

26.

Nasr A, Langer JC (2007) Evolution of the technique in the transanal pull-through for Hirschsprung’s disease: effect on outcome. J Pediatr Surg 42(1):36–39CrossRefPubMed

27.

Onishi S, Nakame K, Yamada K, Yamada W, Kawano T, Mukai M et al (2016) Long-term outcome of bowel function for 110 consecutive cases of Hirschsprung’s disease: Comparison of the abdominal approach with transanal approach more than 30 years in a single institution—is the transanal approach truly beneficial for bowel function? J Pediatr Surg 51(12):2010–2014CrossRefPubMed

28.

Hadidi A (2003) Transanal endorectal pull-through for Hirschsprung’s disease: experience with 68 patients. J Pediatr Surg 38(9):1337–1340CrossRefPubMed

29.

Liu DC, Rodriguez J, Hill CB, Loe WA Jr (2000) Transanal mucosectomy in the treatment of Hirschsprung’s disease. J Pediatr Surg 35(2):235–238CrossRefPubMed

30.

Langer JC, Seifert M, Minkes RK (2000) One-stage Soave pull-through for Hirschsprung’s disease: a comparison of the transanal and open approaches. J Pediatr Surg 35(6):820–822CrossRefPubMed

31.

Marty TL, Seo T, Matlak ME, Sullivan JJ, Black RE, Johnson DG (1995) Gastrointestinal function after surgical correction of Hirschsprung’s disease: long-term follow-up in 135 patients. J Pediatr Surg 30(5):655–658CrossRefPubMed

32.

Marquez TT, Acton RD, Hess DJ, Duval S, Saltzman DA (2009) Comprehensive review of procedures for total colonic aganglionosis. J Pediatr Surg 44(1):257–265CrossRefPubMed

33.

Ksia A, Yengui H, Saad MB, Sahnoun L, Maazoun K, Rachida L et al (2013) 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. Afr J Pediatr Surg 10(4):362–366CrossRef

34.

Bjornland K, Pakarinen MP, Stenstrom P et al (2017) A Nordic multicenter survey of long-term bowel function after transanal endorectal pull-through in 200 patients with rectosigmoid Hirschsprung’s disease. J Pediatr Surg 52(9):1458–1464CrossRefPubMed

Titel: Hirschsprung’s disease in the laparoscopic transanal pull-through era: implications of age at surgery and technical aspects
verfasst von: Go Miyano
Masahiro Takeda
Hiroyuki Koga
Manabu Okawada
Nana Nakazawa-Tanaka
Junya Ishii
Takashi Doi
Geoffrey J. Lane
Tadaharu Okazaki
Masahiko Urao
Atsuyuki Yamataka
Publikationsdatum: 05.10.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 2/2018
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-017-4187-z

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Hirschsprung’s disease in the laparoscopic transanal pull-through era: implications of age at surgery and technical aspects

Abstract