Primary transanal Swenson pull-through operation for Hirschsprung's disease

Area of Science:

• Pediatric Surgery
• Gastrointestinal Surgery
• Congenital Disorders

Background:

• Hirschsprung's disease (HD) is a congenital condition affecting the large intestine.
• Surgical intervention is the primary treatment for HD.
• The transanal Swenson pull-through operation (TSPT) is a novel technique for HD management.

Purpose of the Study:

• To describe the authors' experience with the transanal Swenson pull-through operation (TSPT).
• To evaluate the safety and short-term outcomes of TSPT in children with Hirschsprung's disease.

Main Methods:

• Retrospective review of 27 children with HD who underwent primary TSPT.
• Surgical technique involves rectosigmoidectomy and coloanal anastomosis.
• Data collected on operative time, hospital stay, complications, and fecal continence.

Main Results:

• The average operative time was 153.5 minutes.
• Average hospital stay was 9.1 days, with no blood transfusions required.
• Complications included anastomotic stricture (6), enterocolitis (3), and urethral injury (1). Fecal continence was achieved in 70.8% at 1 year and 77.8% at 2 years.

Conclusions:

• Primary TSPT is a viable and safe alternative surgical technique for pediatric Hirschsprung's disease.
• The TSPT procedure is technically straightforward with acceptable short-term results.
• Long-term follow-up is essential to fully ascertain the benefits of TSPT.