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A follow-up study on postoperative function after a transanal Soave 1-stage endorectal pull-through procedure for

Yanlei Huang1, Shan Zheng, Xianmin Xiao

  • 1Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai 200032, PR China.

Journal of Pediatric Surgery
|September 10, 2008
PubMed

Insights

The transanal Soave (TAS) procedure offers a cost-effective and efficient surgical option for Hirschsprung

Area of Science:

  • Pediatric surgery
  • Gastroenterology
  • Colorectal surgery

Background:

  • Hirschsprung's disease (HD) is a congenital condition affecting the large intestine, causing difficulties with bowel movements.
  • Surgical intervention is necessary to remove the affected aganglionic bowel segment.
  • Various surgical techniques exist, including the Soave procedure (via laparotomy or laparoscopy) and the Ikeda-Soper procedure, with transanal Soave (TAS) emerging as a minimally invasive option.

Purpose of the Study:

  • To evaluate and compare the effectiveness of the transanal Soave (TAS) procedure for Hirschsprung's disease (HD).
  • To assess postoperative bowel function and clinical outcomes in children undergoing TAS compared to other surgical methods.
  • To determine the suitability of the TAS procedure for different types of HD.

Main Methods:

  • A comparative study involving 44 patients undergoing TAS, 35 with laparotomy Soave, 29 with laparoscopic Soave, and 39 with Ikeda-Soper procedures.
  • Patients were followed for 1-5 years post-surgery.
  • Outcomes were evaluated using Kelly's score for bowel movements and anorectal manometry for functional assessment.

Main Results:

  • The TAS procedure demonstrated significantly reduced operative time, costs, preoperative preparation, fasting duration, and hospitalization compared to laparotomy/laparoscopic Soave and Ikeda-Soper procedures.
  • No significant differences in short-term or long-term complications were observed between Soave variations.
  • While TAS and Ikeda-Soper showed comparable long-term bowel function and manometric results, TAS had a lower incidence of postoperative enterocolitis than the traditional Soave procedure.

Conclusions:

  • The transanal Soave (TAS) procedure is a more suitable and feasible surgical option for infants with short-segment and common-type Hirschsprung's disease.
  • TAS offers advantages in terms of reduced resource utilization and comparable functional outcomes.
  • The study supports TAS as an effective alternative to traditional Soave and Ikeda-Soper procedures.
Abstract

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