Related Experiment Video
Updated: Mar 19, 2026
Diagnosis of Hirschsprung's Disease by Immunostaining Rectal Suction Biopsies for Calretinin, S100 Protein and Protein Gene Product 9.5
Published on: April 26, 2019
Effectiveness of various surgical methods in treatment of Hirschsprung's disease in children
Insights
Transanal endorectal pull-through surgery for Hirschsprung's disease shows better outcomes with fewer complications. This method is more effective than other surgical options for treating this common enteric nervous system disorder.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Developmental Biology
Background:
- Hirschsprung's disease is a congenital disorder affecting the enteric nervous system, leading to distal bowel malformation.
- Current surgical treatments, while life-saving, are linked to significant postoperative complications.
Purpose of the Study:
- To compare the effectiveness of transanal endorectal pull-through versus other surgical methods for rectosigmoid Hirschsprung's disease.
- To evaluate the incidence and severity of complications associated with different surgical approaches.
Main Methods:
- Retrospective analysis of 84 patients operated for Hirschsprung's disease between 1997 and 2012.
- Patients were divided into two groups: transanal endorectal pull-through (n=30) and other procedures (Soave, Duhamel, Swenson; n=54).
- Outcomes assessed included age at operation, complication rates, need for colostomy, and reoperation rates.
Main Results:
- The transanal group had a significantly lower mean age at operation (9.41 months) compared to the other procedures group (16.8 months).
- Complications occurred in 10% of the transanal group versus 30% in the other procedures group (p < 0.05).
- The transanal group required fewer reoperations (1.00 average) and no prior colostomy, unlike the other procedures group.
Conclusions:
- Transanal endorectal pull-through is a more effective surgical treatment for rectosigmoid Hirschsprung's disease.
- This technique is associated with earlier surgical intervention, lower complication rates, and fewer reoperations.
- The transanal approach offers advantages including reduced scarring and improved patient outcomes.
Background/Aim:
Hirschsprung's disease is the most common identifiable developmental disorder of the enteric nervous system, characterized by a failure of its formation in a variable segment of distal bowel. Currently available surgical therapies for Hirschsprung's disease, although lifesaving, are associated with numerous complications. The aim of our study was to evaluate the effectiveness of different surgical methods and the incidence of serious complications after radical surgery of rectosigmoid Hirschsprung's disease.
Methods:
A retrospective analysis, from June 1997 until May 2012 was carried out on 84 patients operated for Hirschsprung's disease of rectosigmoid colon. Transanal endorectal pull-through was performed in 30 (35.7%) patients (group I), while 54 (64.3%) patients were operated by other (Soave, Duhamel or Swenson) procedures (group II). The age at operation, the incidence and severity of postoperative complications, the need for previous colostomy and the number of reoperations are countered in order to evaluate the efficacy of surgical procedures.
Results:
In the group I, the mean age at operation was 9.41 +/- 6.37 months and in the group II the mean age at operation was 16.8 +/- 13.9 months which was significantly higher (p < 0.01). In the group I there were only 3 (10%) patients with complications, one (3/6) of them was prone to only one redo procedure (1.00 +/- 0.00) and there was no need for previous colostomy in all patients (100%). In the group II there were 16 (30%) patients with significantly frequent complications (p < 0.05), about 2 reoperations on the average (1.94 +/- 1.84) in 4 of them (25%) and 22 (41%) redo procedures, which was, in total, significantly higher than in the group I (p < 0.01). Only Soave's procedure was performed without previous colostomy in 20 (37/6) patients.
Conclusion:
Transanal endorectal pull-through in surgical treatment of patients with Hirschsprung's disease is more effective than other procedures concerning earlier onset, low incidence and less severe complications, which would require further operations, and no scars.
