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Two surgical techniques, Deloyers and Turnbull, effectively address challenges in Hirschsprung disease affecting the transverse colon. These methods facilitate colon mobilization for pull-through procedures, improving surgical outcomes in pediatric patients.

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AganglionosisColonic rotationHirschsprungLong-segment

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Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Medical Devices

Background:

  • Hirschsprung disease involving the splenic flexure or proximal colon presents significant surgical challenges.
  • Mobilizing the transverse colon for pull-through procedures can lead to distal ileum obstruction or insufficient length for pelvic anastomosis.

Purpose of the Study:

  • To describe two surgical techniques, Deloyers and Turnbull, for facilitating transverse colon mobilization in Hirschsprung disease.
  • To evaluate the outcomes of these techniques in patients requiring pull-through surgery.

Main Methods:

  • Retrospective analysis of 13 patients operated on between April 2017 and April 2024.
  • Detailed description of the Turnbull technique (mesenteric defect creation) and Deloyers technique (right colon rotation).
  • Analysis of patient demographics, surgical history, technique used, complications, and follow-up outcomes.

Main Results:

  • 13 patients (12 boys, 1 girl) were included, with a median pull-through age of 16 months.
  • Turnbull technique used for middle transverse colon aganglionosis (4 patients); Deloyers technique for proximal transverse colon aganglionosis (9 patients).
  • Median follow-up was 4.5 years, with one patient awaiting stoma takedown.

Conclusions:

  • The Turnbull and Deloyers techniques are effective surgical options for Hirschsprung disease involving the transverse colon.
  • These methods aid in mobilizing the transverse colon, potentially reducing complications associated with pull-through procedures.