Heart-shaped anastomosis for Hirschsprung's disease: Operative technique and long-term follow-up
Guo Wang1, Xiao-Yi Sun, Ming-Fa Wei
1Department of Pediatric Surgery, Tongji Hospital Affiliated Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China. gwang@tjh.tjmu.edu.cn
Insights
The heart-shaped anastomosis technique for Hirschsprung's disease (HD) shows a low complication rate. This surgical approach offers a better therapeutic effect compared to traditional methods.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Hirschsprung's disease (HD) is a congenital condition affecting the large intestine.
- Effective surgical management is crucial for long-term patient outcomes.
Purpose of the Study:
- To evaluate the long-term therapeutic efficacy of the "heart-shaped" anastomosis technique in patients with Hirschsprung's disease.
- To assess the operative outcomes and complication rates associated with this specific surgical approach.
Main Methods:
- A retrospective analysis was conducted on 193 patients who underwent one-stage "heart-shaped" anastomosis for Hirschsprung's disease between January 1986 and October 1997.
- Follow-up data was available for 152 patients (79% follow-up rate), allowing for the assessment of both early and late postoperative complications.
Main Results:
- Early complications occurred in 7.8% of patients, including urine retention, enteritis, anastomotic stricture, and intestinal obstruction. No cases of abdominal infection, wound infection, anastomotic leakage, or death were reported.
- Late complications were observed in 11.4% of patients, such as adhesive intestinal obstruction, longer anal, incision hernia, enteritis, and stool soiling. Importantly, no instances of constipation or incontinence were noted.
Conclusions:
- The "heart-shaped" anastomosis procedure for Hirschsprung's disease demonstrates favorable early and late postoperative complication rates.
- This technique provides a superior therapeutic effect compared to classic surgical procedures for Hirschsprung's disease.
Aim:
To study the long-term therapeutic effect of "heart-shaped" anastomosis for Hirschsprung's disease.
Methods:
From January 1986 to October 1997, we performed one-stage "heart-shaped" anastomosis for 193 patients with Hirschsprung's disease (HD). One hundred and fifty-two patients were followed up patients (follow-up rate 79%). The operative outcome and postoperative complications were retrospectively analyzed.
Results:
Early complications included urine retention in 2 patients, enteritis in 10, anastomotic stricture in 1, and intestinal obstruction in 2. No infection of abdominal cavity or wound and anastomotic leakage or death occurred in any patients. Late complications were present in 22 cases, including adhesive intestinal obstruction in 2, longer anal in 5, incision hernia in 2, enteritis in 6, occasional stool stains in 7 and 6 related with improper diet. No constipation or incontinence occurred in any patient.
Conclusion:
The early and late postoperative complication rates were 7.8% and 11.4% respectively in our "heart-shaped anastomosis" procedure. "Heart-shaped" anastomosis procedure for Hirschsprung's disease provides a better therapeutic effect compared to classic procedures.
