Ju Yeon Lee; Jung Hyun Choi; Jung-Man Namgung; Dae Yeon Kim; Sung-Cheol Kim

doi: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

Ju Yeon Lee^1,2, Jung Hyun Choi^1,2, Jung-Man Namgung^1,2, Dae Yeon Kim^1,2, Sung-Cheol Kim^1,2

Journal of the Korean Association of Pediatric Surgeons 2016;22(2):38-41.
Published online: December 22, 2016

DOI: https://doi.org/10.13029/jkaps.2016.22.2.38

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

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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ABSTRACT
NOTES
REFERENCES

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

NOTES

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

REFERENCES

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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.

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.

Figure & Data

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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

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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

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

Table 1

Demographics of Patients

Values are presented as n only or mean±SD.

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 Demographics of Patients

Values are presented as n only or mean±SD.

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.

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

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ABSTRACT

NOTES

REFERENCES

Demographics of Patients

Result of the Procedure

Figure & Data

References

Citations

CITE

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Include:

Demographics of Patients

Result of the Procedure

Table 1

Table 2

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