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[Transanal endorectal pull-through alone as treatment of Hirschsprung's disease]
V Juliá1, M Castañón, X Tarrado
1Servicio de Cirugía Pediátrica, Unidad Integrada Hospital Clínic-Hospital Sant Joan de Déu, Universitat de Barcelona.
Insights
This study shows the De la Torre technique for Hirschsprung disease (HD) offers rapid recovery with high family satisfaction. The transanal approach resulted in minimal complications for rectosigmoid aganglionism treatment.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Innovation
Context:
- Hirschsprung disease (HD) is a congenital disorder characterized by rectosigmoid aganglionism.
- Surgical intervention is the primary treatment for HD.
- Minimally invasive techniques are increasingly preferred for pediatric surgical conditions.
Purpose:
- To present the surgical experience with the De la Torre technique for treating Hirschsprung disease.
- To evaluate the efficacy and outcomes of this transanal approach in pediatric patients.
- To highlight modifications made to the De la Torre technique.
Summary:
- Seven children with recto-sigmoid aganglionism underwent surgery using a modified De la Torre transanal technique.
- The procedure demonstrated no intraoperative or early postoperative complications.
- Patients experienced rapid oral feeding initiation (average 2.4 days) and short hospital stays (average 5.2 days).
- Late complications included one anastomotic stricture and one constipation, both managed successfully as outpatients.
Impact:
- The transanal-only approach facilitates rapid patient recovery.
- High family satisfaction is attributed to the absence of abdominal scars.
- This technique is considered a preferred treatment option for rectosigmoid aganglionism.
Unlabelled:
The aim of this work is to present our experience in the treatment of Hirschsprung's disease (HD) with the technique described by De la Torre.
Materials And Methods:
Seven children diagnosed with recto-sigmoid aganglionism have been treated with this surgical technique, to which a few modifications have been done.
Results:
There were no intra- nor early postoperative complications. Surgical time ranged 150 to 240 minutes (average 198). All children began oral feedings 2 or 3 days postoperatively (average 2.4). Hospital stay averaged 5.2 days. Follow-up ranges from 6 months to 3 years (average 16 months). Two late complications were seen--one anastomotic stricture and one constipation--and successfully treated as out patients.
Conclusions:
The transanal only approach carries a rapid recovery. Family satisfaction is high because of the lack of scars. We believe this is the treatment of choice when confronting rectosigmoid aganglionism.
