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What is the most common complication after one-stage transanal pull-through in infants with Hirschsprung's disease?

M Rouzrokh1, A T Khaleghnejad, L Mohejerzadeh

  • 1Pediatric Surgery Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. mohsen_rouzrokh@yahoo.com

Pediatric Surgery International
|July 16, 2010
PubMed

Insights

The one-stage transanal pull-through (TAPT) procedure for Hirschsprung's disease (HD) shows excellent results with low complications. Prophylactic anal bouginage effectively prevents anastomotic strictures, a common issue.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Congenital Disorders

Background:

  • Hirschsprung's disease (HD) is a common congenital condition diagnosed via rectal biopsy.
  • The rectosigmoid junction is affected in 80% of HD cases.
  • The one-stage transanal pull-through (TAPT) procedure is increasingly used but carries potential complications.

Purpose of the Study:

  • To evaluate the efficacy and complication rates of the TAPT procedure for Hirschsprung's disease.
  • To assess the impact of prophylactic anal bouginage on anastomotic stricture formation.

Main Methods:

  • A 4-year study included 86 infants diagnosed with HD.
  • All patients underwent a Swenson-like TAPT procedure.
  • Prophylactic Hegar dilatation was initiated in 30 cases two weeks post-operation.

Main Results:

  • Anal stricture occurred in 14% of cases, managed by dilation or surgery.
  • Enterocolitis was observed in 5% of patients, treated medically.
  • No anastomotic strictures were noted after implementing prophylactic anal bouginage.

Conclusions:

  • TAPT offers significant advantages with excellent outcomes and low complication rates for HD.
  • Anastomotic stricture is the most frequent complication, effectively managed by prophylactic bouginage.
  • Prophylactic anal bouginage with a Hegar probe at two weeks post-TAPT is recommended.
Abstract

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