Transanal one-stage endorectal pull-through for Hirschsprung's disease: a multicenter study

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Colorectal Surgery

Background:

• Hirschsprung's disease (HD) is a congenital condition affecting the large intestine.
• The transanal endorectal pull-through (TEPT) is a minimally invasive surgical approach for HD.
• Evaluating the safety and efficacy of the one-stage TEPT is crucial for pediatric surgical management.

Purpose of the Study:

• To assess the safety and efficacy of the one-stage transanal endorectal pull-through (TEPT) procedure.
• To evaluate functional outcomes and complications in children undergoing TEPT for Hirschsprung's disease.
• To determine the feasibility of the one-stage TEPT in a multi-center setting.

Main Methods:

• A prospective study involving 149 children with Hirschsprung's disease.
• All patients underwent a one-stage TEPT procedure across five Egyptian academic centers.
• Follow-up data, including functional results and complications, were collected for a median of 12 months.

Main Results:

• The one-stage TEPT procedure was performed successfully in most patients, with a mean operating time of 120.2 minutes.
• Postoperative complications included enterocolitis (26 patients) and transient perianal excoriation (48 patients).
• Complete anorectal continence was achieved in 83.3% of children over 3 years old.

Conclusions:

• The one-stage TEPT technique is a feasible and safe option for selected children with rectosigmoid Hirschsprung's disease.
• The procedure is easily learned and associated with excellent clinical outcomes.
• TEPT offers a promising surgical solution for managing Hirschsprung's disease across all age groups.