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Transanal endorectal stepwise gradient muscular cuff cutting pull-through method: Technique refinements and
Zebing Zheng1, Fan Zhang2, Zhu Jin1
1Department of Pediatric General Thoracic and Urinary Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China.
Experimental and Therapeutic Medicine
|September 7, 2018
Summary
Laparoscopy-assisted pull-through (LPT) surgery for Hirschsprung
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Surgical Innovation
Background:
- Hirschsprung's disease (HD) treatment traditionally retains a muscular cuff.
- A modified stepwise gradient muscular cuff cutting pull-through method has been developed.
Purpose of the Study:
- To compare patient prognosis between transanal endorectal pull-through (TEPT) and laparoscopy-assisted pull-through (LPT) for HD.
- To provide evidence for clinical decision-making in HD surgical treatment.
Main Methods:
- Retrospective review of 172 patients (≥3 years) who underwent TEPT (n=94) or LPT (n=78) for HD.
- Data collection included preoperative, intraoperative, and postoperative outcomes.
- Long-term outcomes assessed via a 12-item questionnaire.
Main Results:
- LPT group showed longer operating times but reduced blood loss and transfusion rates.
- No significant differences in early complications, oral feeding, or hospital stay.
- TEPT group had higher rates of soiling and constipation; LPT showed increased bowel movement frequency post-surgery.
Conclusions:
- The stepwise gradient muscular cuff cutting pull-through method is safe and effective for HD.
- Laparoscopy-assisted pull-through (LPT) is a promising surgical approach for children with Hirschsprung's disease.
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