Single Stage Transanal Endorectal Pull-through Operation for Hirschsprung’s Disease in Neonate: A Single Center Experience.
10.13029/jkaps.2016.22.2.38
- Author:
Ju Yeon LEE
1
;
Jung Hyun CHOI
;
Jung Man NAMGUNG
;
Dae Yeon KIM
;
Sung Cheol KIM
Author Information
1. Department of Surgery, University of Ulsan College of Medicine, Seoul, Korea. kimdy@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Hirschsprung disease;
Transanal pull-through;
Single stage surgery;
Newborn infant
- MeSH:
Botulinum Toxins;
Chungcheongnam-do;
Constriction, Pathologic;
Defecation;
Fecal Impaction;
Follow-Up Studies;
Hirschsprung Disease;
Humans;
Infant, Newborn*;
Medical Records;
Pathology;
Retrospective Studies;
Soil
- From:Journal of the Korean Association of Pediatric Surgeons
2016;22(2):38-41
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The single stage transanal pull-through (SSPT) for Hirschsprung’s disease is becoming the most popular procedure. This single center study compared the result of single stage operation with two-stage operation for Hirschsprung’s disease in neonates. METHODS: We retrospectively reviewed medical records of all patients who were diagnosed as Hirschsprung’s disease and underwent SSPT or two-stage operation operation in Asan Medical Center between January 2003 and July 2014. RESULTS: There were 17 SSPT and 28 two-stage operation. The mean age of SSPT group was 14.2±7.1 days, and the mean age of two-stage operation group was 15.4±8.6 days for stomy formation, and 188.6±36.3 days for Duhamel operation. The operation time of SSPT was shorter than Duhamel operation (145.0±37.0 minutes vs. 193.0±36.0 minutes, p<0.001). The mean follow-up period of SSPT and two-stage operation was 35.5±34.9 months (range, 2-132 months) and 56.6±35.5 months (range, 1-121 months), respectively. Defecation problem rate such as fecal soiling or fecal impaction showed no significant difference between the two groups (p=0.719). Two SSPT patients required botulinum toxin injection due to rectal stenosis. Three patients of SSPT group underwent re-do endorectal pull-through due to remnant aganglionic or hypoganglionic bowel. CONCLUSION: The SSPT showed shorter hospital days. However, few patients experienced rectal stenosis, but were manageable with botulinum toxin injection. The SSPT requires experienced-pathologist, as well as surgeon, because intra-operation pathology reading is critical for appropriate SSPT. SSPT is a feasible and reasonable option to treat Hirschsprung’s disease.
