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Colorectal resection and anal anastomosis with an intraluminal stapler in Hirschsprung's disease
1Department of Pediatric Surgery, Ostra Sjukhuset, S-416 85 Goteborg, Sweden
Insights
This study evaluated a stapled coloanal anastomosis for Hirschsprung
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Innovation
Background:
- Hirschsprung's disease is a congenital condition affecting the large intestine.
- Surgical intervention is necessary to restore normal bowel function.
Purpose of the Study:
- To assess the safety and efficacy of a stapled pull-through resection and circular coloanal anastomosis in pediatric patients with Hirschsprung's disease.
Main Methods:
- Twenty pediatric patients (5 months - 4 years) underwent pull-through resection with stapled coloanal anastomosis (11 single-stapling, 9 double-stapling).
- Postoperative assessments included isopaque rectography and clinical examination (palpation, Hegar dilators).
Main Results:
- Isopaque rectography confirmed intact anastomoses in all 20 patients, with no leaks.
- Four patients showed signs of stenosis on palpation, but all were successfully treated with Hegar dilators, with no residual stenosis at 3-month follow-up.
Conclusions:
- Stapled circular coloanal anastomosis is a safe and effective technique for Hirschsprung's disease in children over 6 months of age.
- The technique demonstrates a low rate of complications and successful functional outcomes.
Abstract:
Twenty patients aged 5 months - 4 years (mean 14 months) with Hirschsprung's disease were operated upon. In all cases a pull-through resection and stapled circular coloanal anastomosis was performed, in 11 with a single-stapling technique and in 9 with double-stapling. Isopaque rectography 4 - 10 days postoperatively showed an intact anastomosis in all 20 patients, i. e., there were no clinical or subclinical leaks. On palpation 4 - 6 weeks postoperatively, there were signs of stenosis in 4 patients. However, no. 9 - 11 Hegar dilators passed easily and there was no residual stenosis at follow-up 3 months after surgery. The technique can be recommended in children over 6 months of age.