Related Experiment Videos
Repeat pull-through surgery for complicated Hirschsprung's disease: indications, techniques, and results
1Department of Surgery, Washington University School of Medicine, St Louis, MO, USA.
Journal of Pediatric Surgery
|August 12, 1999
Summary
Repeat pull-through surgery for Hirschsprung's disease (HD) is safe and effective in selected patients. The Duhamel technique is often preferred, and while outcomes are generally good, anal sphincter hypertonicity can cause persistent issues.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Disorders
Background:
- Hirschsprung's disease (HD) often requires pull-through surgery.
- While most operations succeed, some children need repeat procedures due to failure.
Observation:
- Nine children with HD underwent repeat pull-through surgery over four years.
- Indications included refractory stricture (3) and acquired aganglionosis (6).
- The Duhamel technique was preferred for reconstruction in most cases.
Findings:
- Complications included wound infection, bleeding, and stoma issues.
- Three patients achieved normal stool patterns; one had intermittent soiling.
- Four patients experienced persistent obstructive symptoms due to sphincter hypertonicity.
Implications:
- Repeat pull-through surgery is a viable option for selected HD patients.
- Duhamel reconstruction is technically favored, and a stoma is not always required.
- Anal sphincter hypertonicity can be a long-term challenge requiring management.