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Original Article

Single Stage Transanal Endorectal Pull-through Operation for Hirschsprung’s Disease in Neonate: A Single Center Experience

Ju Yeon Lee1,2, Jung Hyun Choi1,2, Jung-Man Namgung1,2, Dae Yeon Kim1,2, Sung-Cheol Kim1,2
Journal of the Korean Association of Pediatric Surgeons 2016;22(2):38-41.
Published online: December 22, 2016

1Department of Surgery, University of Ulsan College of Medicine, Seoul, Korea.

2Department of Pediatric Surgery, Asan Medical Center Children’s Hospital, Seoul, Korea.

Correspondence: Dae Yeon Kim, Department of Pediatric Surgery, Asan Medical Center Children’s Hospital, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: +82-2-3010-3961, Fax: +82-2-3010-6863, kimdy@amc.seoul.kr
• Received: June 29, 2016   • Revised: October 17, 2016   • Accepted: October 18, 2016

Copyright © 2016 by the Korean Association of Pediatric Surgeons

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • 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.
  • Keywords: Hirschsprung disease; Transanal pull-through; Single stage surgery; Newborn infant

No potential conflict of interest relevant to this article was reported.

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Table 1

Demographics of Patients

Values are presented as n only or mean±SD.

SSPT, single stage transanal endorectal pull-through; S, stomy formation; D, Duhamel operation; M, male; F, female; LR, lower rectum; UR, upper rectum; RSJ, rectosigmoid junction; SC, sigmoid colon; DC, descending colon; MR, mid-rectum.

jkaps-22-38-i001.jpg
Table 2

Result of the Procedure

Values are presented as mean±SD or n only.

SSPT, single stage transanal endorectal pull-through; S, stomy formation; D, Duhamel operation; POD, postoperative day.

jkaps-22-38-i002.jpg

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Single Stage Transanal Endorectal Pull-through Operation for Hirschsprung’s Disease in Neonate: A Single Center Experience
J Korean Assoc Pediatr Surg. 2016;22(2):38-41.   Published online December 22, 2016
DOI: https://doi.org/10.13029/jkaps.2016.22.2.38
Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
Format:
Include:
Single Stage Transanal Endorectal Pull-through Operation for Hirschsprung’s Disease in Neonate: A Single Center Experience
J Korean Assoc Pediatr Surg. 2016;22(2):38-41.   Published online December 22, 2016
DOI: https://doi.org/10.13029/jkaps.2016.22.2.38
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Single Stage Transanal Endorectal Pull-through Operation for Hirschsprung’s Disease in Neonate: A Single Center Experience
Single Stage Transanal Endorectal Pull-through Operation for Hirschsprung’s Disease in Neonate: A Single Center Experience

Demographics of Patients

Values are presented as n only or mean±SD.

SSPT, single stage transanal endorectal pull-through; S, stomy formation; D, Duhamel operation; M, male; F, female; LR, lower rectum; UR, upper rectum; RSJ, rectosigmoid junction; SC, sigmoid colon; DC, descending colon; MR, mid-rectum.

Result of the Procedure

Values are presented as mean±SD or n only.

SSPT, single stage transanal endorectal pull-through; S, stomy formation; D, Duhamel operation; POD, postoperative day.

Table 1 Demographics of Patients

Values are presented as n only or mean±SD.

SSPT, single stage transanal endorectal pull-through; S, stomy formation; D, Duhamel operation; M, male; F, female; LR, lower rectum; UR, upper rectum; RSJ, rectosigmoid junction; SC, sigmoid colon; DC, descending colon; MR, mid-rectum.

Table 2 Result of the Procedure

Values are presented as mean±SD or n only.

SSPT, single stage transanal endorectal pull-through; S, stomy formation; D, Duhamel operation; POD, postoperative day.

Table 1

Table 2

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