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[Transanal pull-through for Hirschsprung disease in new borns and infants]
1Department of Pediatic Surgery, Peking University First Hospital, Beijing 100034, China. www.bdd.yyy.com.cn
Insights
Transanal pull-through surgery is an effective and safe treatment for newborns and infants with Hirschsprung's disease. This minimally invasive approach offers quick recovery and minimal complications for pediatric patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Abnormalities
Background:
- Hirschsprung's disease is a congenital condition affecting the large intestine, causing difficulty passing stool.
- Current surgical options for Hirschsprung's disease in infants can be complex.
Purpose of the Study:
- To evaluate the efficacy and safety of the transanal pull-through technique for congenital Hirschsprung's disease in infants.
- To introduce this minimally invasive surgical approach for pediatric patients.
Main Methods:
- A retrospective review of 43 infant cases undergoing transanal pull-through for Hirschsprung's disease.
- Surgical technique involved rectal mucosectomy, posterior rectal muscularis resection, and coloanal anastomosis.
Main Results:
- The transanal pull-through procedure was successfully performed in all 43 cases with minimal blood loss.
- Patients experienced rapid recovery, with early feeding (1-2 days) and short hospital stays (5-7 days).
- No significant complications such as urinary retention or wound infection were observed; only 2 cases reported soiling.
Conclusions:
- The transanal pull-through is an ideal surgical option for congenital Hirschsprung's disease in newborns and infants.
- This technique is characterized by its simplicity, minimal invasiveness, rapid recovery, and low complication rate.
Objective:
To introduce the transanal pull-through for congenital Hirschsprung's disease in new borns and infants.
Methods:
The 43 cases on whom were performed transanal pull-through for Hirschsprung's disease were reviewed. The ages of the patients were 14 days-12 months. The technique included a rectal mucosectomy at the proximal to the dentate line, separating mucosas from rectal wall to the peritoneal reflection. The part of rectal muscularis below the peritoneal was resected posteriorly. An anastomosis was made between the pull-through ganglionic colon and anus.
Results:
In the 43 cases the operations were easily accomplished by excising the injured intestine. The blood lost was small. The patients took food after 1-2 days of operation. discharged 5-7 days later. No retention of urine and no infection of incision wound were observed. Total follow up lasted 3-9 months. Defecation was normal, and there was no stricture of anus. Only 2 cases had soiling by chance.
Conclusion:
Simple transanal pull-through is an ideal type of operation for congenital Hirschsprung's disease in new borns and infants. It is an easy operation, with less injury, quick recovery and rare complication.