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Erschienen in: Irish Journal of Medical Science (1971 -) 2/2017

29.03.2016 | Original Article

Transanal endorectal pull-through for Hirschsprung’s disease: experience with 50 patients

verfasst von: Ü. Adıgüzel, K. Ağengin, İ. Kırıştıoğlu, H. Doğruyol

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 2/2017

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Abstract

Introduction

Transanal endorectal pull-through (TEPT) is the latest advancement in the treatment of Hirschsprung’s disease (HD). The aim of this study was to evaluate the safety and efficacy of TEPT as a definitive treatment for patients with HD.

Patients and methods

A retrospective study of 50 patients who underwent TEPT at Uludağ University, Bursa, Turkey, between June 2001 and April 2012 was conducted. These patients were evaluated with regard to their age, sex, preoperative findings, and length of the aganglionic segment, intraoperative and postoperative complications, and results of the follow-up.

Results

Forty-three patients were boys and seven were girls. The median age was 3 months (range 0–96 months). The most common symptoms were abdominal distention and vomiting. HD was diagnosed in 38 patients using barium enema and anorectal manometry, in 11 patients using rectal biopsy, and in 1 patient using laparotomy with biopsy. The mean time from the beginning of enteral feeding was 2.2 ± 1.1 days. The mean follow-up period was 26.7 ± 20.8 months. The postoperative complications included transient perianal excoriation in 12 patients, enterocolitis in 10, anastomotic stricture in 3, soiling in 3, recurrent constipation in 2, prolapse of the pulled through colon in 1, anastomotic leak in 1, and rectovestibular fistula in 1 patient.

Conclusions

TEPT is a feasible and safe procedure in children with rectosigmoid HD.
Literatur
1.
Zurück zum Zitat De la Torre-Mondragon L, Ortega-Salgado JA (1998) Transanal endorectal pull-through for Hirschsprung’s disease. J Pediatr Surg 33(8):1283–1286CrossRefPubMed De la Torre-Mondragon L, Ortega-Salgado JA (1998) Transanal endorectal pull-through for Hirschsprung’s disease. J Pediatr Surg 33(8):1283–1286CrossRefPubMed
2.
Zurück zum Zitat Teitelbaum DH, Cilley RE, Sherman NJ, Bliss D, Uitvlugt ND, Renaud EJ, Kirstioglu I 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 Teitelbaum DH, Cilley RE, Sherman NJ, Bliss D, Uitvlugt ND, Renaud EJ, Kirstioglu I 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
3.
Zurück zum Zitat Teeraratkul S (2003) Transanal one-stage endorectal pull-through for Hirschsprung’s disease in infants and children. J Pediatr Surg 38(2):184–187CrossRefPubMed Teeraratkul S (2003) Transanal one-stage endorectal pull-through for Hirschsprung’s disease in infants and children. J Pediatr Surg 38(2):184–187CrossRefPubMed
4.
Zurück zum Zitat Elhalaby EA, Hashish A, Elbarbary MM, Soliman HA, Wishahy MK, Elkholy A et al (2004) Transanal one-stage endorectal pull-through for Hirschsprung’s disease: a multicenter study. J Pediatr Surg 39(3):345–351CrossRefPubMed Elhalaby EA, Hashish A, Elbarbary MM, Soliman HA, Wishahy MK, Elkholy A et al (2004) Transanal one-stage endorectal pull-through for Hirschsprung’s disease: a multicenter study. J Pediatr Surg 39(3):345–351CrossRefPubMed
5.
Zurück zum Zitat Hadidi A (2003) Transanal endorectal pull-through for Hirschsprung’s disease: experience with 68 patients. J Pediatr Surg 38(9):1337–1340CrossRefPubMed Hadidi A (2003) Transanal endorectal pull-through for Hirschsprung’s disease: experience with 68 patients. J Pediatr Surg 38(9):1337–1340CrossRefPubMed
6.
Zurück zum Zitat Langer JC, Durrant AC, De la Torre L, Teitelbaum DH, Minkes RK, Caty MG et al (2003) One-stage transanal Soave pullthrough for Hirschsprung disease: a multicenter experience with 141 children. Ann Surg 238(4):569–583PubMedPubMedCentral Langer JC, Durrant AC, De la Torre L, Teitelbaum DH, Minkes RK, Caty MG et al (2003) One-stage transanal Soave pullthrough for Hirschsprung disease: a multicenter experience with 141 children. Ann Surg 238(4):569–583PubMedPubMedCentral
7.
Zurück zum Zitat Dasgupta R, Langer JC (2005) Transanal pull-through for Hirschsprung disease. Semin Pediatr Surg 14(1):64–71CrossRefPubMed Dasgupta R, Langer JC (2005) Transanal pull-through for Hirschsprung disease. Semin Pediatr Surg 14(1):64–71CrossRefPubMed
8.
Zurück zum Zitat 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 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
9.
Zurück zum Zitat Loening-Baucke V, Pringle KC, Ekwo EE (1985) Anorectal manometry for the exclusion of Hirschsprung’s disease in neonates. J Pediatr Gastroenterol Nutr 4(4):596–603CrossRefPubMed Loening-Baucke V, Pringle KC, Ekwo EE (1985) Anorectal manometry for the exclusion of Hirschsprung’s disease in neonates. J Pediatr Gastroenterol Nutr 4(4):596–603CrossRefPubMed
10.
Zurück zum Zitat Adıgüzel Ü, Kırıştıoğlu İ, Doğruyol H (2009) Myectomy and sphincteromyectomy for short segment Hirschsprung’s disease. J Turkish Association of Pediatric Surgery 23:35–39 Adıgüzel Ü, Kırıştıoğlu İ, Doğruyol H (2009) Myectomy and sphincteromyectomy for short segment Hirschsprung’s disease. J Turkish Association of Pediatric Surgery 23:35–39
11.
Zurück zum Zitat Alizai NK, Batcup G, Dixon MF, Stringer MD (1998) Rectal biopsy for Hirschsprung’s disease: what is the optimum method? Pediatr Surg Int 13(2–3):121–124CrossRefPubMed Alizai NK, Batcup G, Dixon MF, Stringer MD (1998) Rectal biopsy for Hirschsprung’s disease: what is the optimum method? Pediatr Surg Int 13(2–3):121–124CrossRefPubMed
13.
Zurück zum Zitat Cusick EL, Buick RG (1995) Injury to the common iliac artery during suction rectal biopsy. J Pediatr Surg 30(1):111–112CrossRefPubMed Cusick EL, Buick RG (1995) Injury to the common iliac artery during suction rectal biopsy. J Pediatr Surg 30(1):111–112CrossRefPubMed
14.
Zurück zum Zitat Rees BI, Azmy A, Nigam M, Lake BD (1983) Complications of rectal suction biopsy. J Pediatr Surg 18(3):273–275CrossRefPubMed Rees BI, Azmy A, Nigam M, Lake BD (1983) Complications of rectal suction biopsy. J Pediatr Surg 18(3):273–275CrossRefPubMed
15.
Zurück zum Zitat de Lorijn F, Kremer LC, Reitsma JB, Benninga MA (2006) Diagnostic tests in Hirschsprung disease: a systematic review. J Pediatr Gastroenterol Nutr 42(5):496–505CrossRefPubMed de Lorijn F, Kremer LC, Reitsma JB, Benninga MA (2006) Diagnostic tests in Hirschsprung disease: a systematic review. J Pediatr Gastroenterol Nutr 42(5):496–505CrossRefPubMed
16.
Zurück zum Zitat De la Torre L, Ortega A (2006) Transanal versus open endorectal pull-through for Hirschsprung’s disease. J Pediatr Surg 35(11):1630–1632CrossRef De la Torre L, Ortega A (2006) Transanal versus open endorectal pull-through for Hirschsprung’s disease. J Pediatr Surg 35(11):1630–1632CrossRef
17.
Zurück zum Zitat Kleinhaus S, Boley SJ, Sheran M, Sieber WK (1979) Hirschsprung’s disease—a survey of the members of the Surgical Section of the American Academy of Pediatrics. J Pediatr Surg 14(5):588–597CrossRefPubMed Kleinhaus S, Boley SJ, Sheran M, Sieber WK (1979) Hirschsprung’s disease—a survey of the members of the Surgical Section of the American Academy of Pediatrics. J Pediatr Surg 14(5):588–597CrossRefPubMed
18.
Zurück zum Zitat Jona JZ, Cohen RD, Georgeson KE, Rothenberg SS (1998) Laparoscopic pull-through procedure for Hirschsprung’s disease. Semin Pediatr Surg 7(4):228–231CrossRefPubMed Jona JZ, Cohen RD, Georgeson KE, Rothenberg SS (1998) Laparoscopic pull-through procedure for Hirschsprung’s disease. Semin Pediatr Surg 7(4):228–231CrossRefPubMed
19.
Zurück zum Zitat 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 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
20.
Zurück zum Zitat Keshtgar AS, Ward HC, Clayden GS, de Sousa NM (2003) Investigations for incontinence and constipation after surgery for Hirschsprung’s disease in children. Pediatr Surg Int 19(1–2):4–8PubMed Keshtgar AS, Ward HC, Clayden GS, de Sousa NM (2003) Investigations for incontinence and constipation after surgery for Hirschsprung’s disease in children. Pediatr Surg Int 19(1–2):4–8PubMed
21.
Zurück zum Zitat Shankar KR, Losty PD, Lamont GL, Turnock RR, Jones MO, Lloyd DA et al (2000) Transanal endorectal coloanal surgery for Hirschsprung’s disease: experience in two centers. J Pediatr Surg 35(8):1209–1213CrossRefPubMed Shankar KR, Losty PD, Lamont GL, Turnock RR, Jones MO, Lloyd DA et al (2000) Transanal endorectal coloanal surgery for Hirschsprung’s disease: experience in two centers. J Pediatr Surg 35(8):1209–1213CrossRefPubMed
22.
Zurück zum Zitat Rescorla FJ, Morrison AM, Engles D, West KW, Grosfeld JL (1992) Hirschsprung’s disease. Evaluation of mortality and long-term function in 260 cases. Arch Surg 127(8):934–941CrossRefPubMed Rescorla FJ, Morrison AM, Engles D, West KW, Grosfeld JL (1992) Hirschsprung’s disease. Evaluation of mortality and long-term function in 260 cases. Arch Surg 127(8):934–941CrossRefPubMed
23.
Zurück zum Zitat Swenson O, Sherman JO, Fisher JH (1973) Diagnosis of congenital megacolon: an analysis of 501 patients. J Pediatr Surg 8(5):587–594CrossRefPubMed Swenson O, Sherman JO, Fisher JH (1973) Diagnosis of congenital megacolon: an analysis of 501 patients. J Pediatr Surg 8(5):587–594CrossRefPubMed
24.
Zurück zum Zitat Elhalaby EA, Coran AG, Blane CE, Hirschl RB, Teitelbaum DH (1995) Enterocolitis associated with Hirschsprung’s disease: a clinical-radiological characterization based on 168 patients. J Pediatr Surg 30(1):76–83CrossRefPubMed Elhalaby EA, Coran AG, Blane CE, Hirschl RB, Teitelbaum DH (1995) Enterocolitis associated with Hirschsprung’s disease: a clinical-radiological characterization based on 168 patients. J Pediatr Surg 30(1):76–83CrossRefPubMed
25.
Zurück zum Zitat Ekema G, Falchetti D, Torri F, Merulla VE, Manciana A, Caccia G (2003) Further evidence on totally transanal one-stage pull-through procedure for Hirschsprung’s disease. J Pediatr Surg 38(10):1434–1439CrossRefPubMed Ekema G, Falchetti D, Torri F, Merulla VE, Manciana A, Caccia G (2003) Further evidence on totally transanal one-stage pull-through procedure for Hirschsprung’s disease. J Pediatr Surg 38(10):1434–1439CrossRefPubMed
26.
Zurück zum Zitat Gao Y, Li G, Zhang X, Xu Q, Guo Z, Zheng B et al (2001) Primary transanal rectosigmoidectomy for Hirschsprung’s disease: preliminary results in the initial 33 cases. J Pediatr Surg 36(12):1816–1819CrossRefPubMed Gao Y, Li G, Zhang X, Xu Q, Guo Z, Zheng B et al (2001) Primary transanal rectosigmoidectomy for Hirschsprung’s disease: preliminary results in the initial 33 cases. J Pediatr Surg 36(12):1816–1819CrossRefPubMed
27.
Zurück zum Zitat Bill AH, Chapman ND (1962) The enterocolitis of Hirschsprung’s disease. Its natural history and treatment. Am J Surg 103:70–74CrossRef Bill AH, Chapman ND (1962) The enterocolitis of Hirschsprung’s disease. Its natural history and treatment. Am J Surg 103:70–74CrossRef
28.
Zurück zum Zitat Teitelbaum DH, Qualman SJ, Caniano DA (1998) Hirschsprung’s disease. Identification of risk factors for enterocolitis. Ann Surg 207(3):240–244CrossRef Teitelbaum DH, Qualman SJ, Caniano DA (1998) Hirschsprung’s disease. Identification of risk factors for enterocolitis. Ann Surg 207(3):240–244CrossRef
29.
Zurück zum Zitat Albanese CT, Jennings RW, Smith B, Bratton B, Harrison MR (1999) Perineal one-stage pull-through for Hirschsprung’s disease. J Pediatr Surg 34(3):377–380CrossRefPubMed Albanese CT, Jennings RW, Smith B, Bratton B, Harrison MR (1999) Perineal one-stage pull-through for Hirschsprung’s disease. J Pediatr Surg 34(3):377–380CrossRefPubMed
Metadaten
Titel
Transanal endorectal pull-through for Hirschsprung’s disease: experience with 50 patients
verfasst von
Ü. Adıgüzel
K. Ağengin
İ. Kırıştıoğlu
H. Doğruyol
Publikationsdatum
29.03.2016
Verlag
Springer London
Erschienen in
Irish Journal of Medical Science (1971 -) / Ausgabe 2/2017
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-016-1446-2

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