Transanal versus open endorectal pull-through for Hirschsprung's disease

Area of Science:

• Pediatric surgery
• Gastrointestinal surgery

Background:

• Hirschsprung's disease (HD) is a congenital condition requiring surgical correction.
• Standard endorectal pull-through techniques often involve laparotomy.
• Transanal endorectal resection and pull-through (TERPT) offers a minimally invasive alternative.

Purpose of the Study:

• To compare the outcomes of TERPT with two open standard endorectal pull-through approaches for Hirschsprung's disease.
• To evaluate operating time, bleeding, complications, and functional results.

Main Methods:

• A retrospective comparison of 28 Hirschsprung's disease patients undergoing endorectal pull-through.
• Patients were divided into three groups: preliminary colostomy with laparotomy (Group I), laparotomy alone (Group II), and TERPT (Group III).
• Statistical analysis included ANOVA using the Kruskal-Wallis test to compare age, operating time, bleeding, complications, and functional outcomes.

Main Results:

• TERPT (Group III) demonstrated significantly less operating time and blood loss compared to open approaches (Groups I and II).
• Fewer complications were observed in the TERPT group, with no instances of intestinal obstruction or abscesses.
• Functional results were comparable across all groups, with 80-90% good outcomes.

Conclusions:

• TERPT is an effective and safe surgical technique for Hirschsprung's disease.
• This minimally invasive approach minimizes blood loss and complications while achieving comparable functional results to open techniques.