Transanal Swenson's operation for recto-sigmoid Hirschsprung's disease

Area of Science:

• Pediatric surgery
• Gastroenterology
• Surgical innovation

Background:

• Hirschsprung's disease requires surgical intervention to remove the affected bowel segment.
• Transanal Swenson's operation is a minimally invasive, single-stage alternative to traditional open procedures.
• Evaluating the efficacy and safety of this novel technique is crucial for pediatric surgical practice.

Purpose of the Study:

• To present the results of the single-stage transanal Swenson's operation for Hirschsprung's disease at our institution.
• To assess the feasibility, safety, and early outcomes of this transanal approach in pediatric patients.
• To determine the correlation between intra-operative and pathological transition zones in guiding resection.

Main Methods:

• Seventeen patients with recto-sigmoid Hirschsprung's disease underwent the transanal Swenson's procedure.
• Diagnosis was confirmed by barium enema and intra-operative assessment of the transition zone.
• A full-thickness colo-anal anastomosis was performed after mobilization and resection of the affected segment.

Main Results:

• The median patient age was 14 months, with a median hospital stay of 4 days.
• Two patients experienced post-operative enterocolitis, and two developed anastomotic strictures.
• No injuries to surrounding structures or voiding disturbances were reported; soiling resolved within 6 weeks.

Conclusions:

• Transanal Swenson's pull-through avoids laparotomy and the complications of other transanal techniques.
• The anatomical transition zone is a reliable landmark for determining resection margins.
• Meticulous surgical technique minimizes the risk of injury to adjacent structures, ensuring favorable outcomes.