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[A modified surgical tehnique in Hirschprung's disease]
Insights
This study evaluated a modified surgical technique for Hirschprung
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Disorders
Context:
- Hirschsprung's disease affects the large intestine, causing bowel obstructions.
- Surgical intervention is the primary treatment for Hirschsprung's disease.
- Evaluating novel surgical techniques is crucial for improving patient outcomes.
Purpose:
- To assess the operative outcomes of a modified surgical technique for Hirschsprung's disease.
- To analyze the efficacy and safety of a two-stage surgical approach involving extra-abdominal anastomosis and transmucosal resection.
Summary:
- A modified two-stage surgical technique for Hirschsprung's disease was applied to 209 pediatric patients over 25 years.
- The technique features extra-abdominal anastomosis and external transmucosal resection, preserving the anterior rectal portion.
- This approach resulted in low mortality, infrequent complications, and favorable functional outcomes in the patient cohort.
Impact:
- The modified technique demonstrates a high success rate in treating Hirschsprung's disease.
- This approach offers a viable and effective surgical option for the majority of affected children.
- Findings support the consideration of this technique as a method of choice in pediatric surgical centers.
Abstract:
The purpose of the study was to evaluate the operative results in patients with Hirschprung's disease, in whom a modified technique was carried out. During a 25-year period, 209 children with Hirschprung's disease were operated on using a modified technique, introduced by Besewits. The patients (177 males and 32 females) were from 4.5 months to 13 years of age, mean 32 months. The essential features of the technique are extra-abdominal anastomosis and external transmucosal resection of aganglionic rectum. Anterior portion of the rectum is preserved, being important for good functional results. The surgery is performed in two stages. In the first stage, normally innervated colon is pulled trough a mucous cylinder of everted rectum. Two weeks later, exteriorized redundant segment of colon is resected at about 0.5 cm from anocutaneus junction. Within the range of numerous contemporary approaches to surgical treatment of Hirschprung's disease, we feel this technique, proved on 209 patients with low mortality, rare complication, and good functional results, is the method of choice for the majority of patients.
