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Eighteen years' experience with neonatal Hirschsprung's disease treated by endorectal pull-through without colostomy
H B So1, J M Becker, D L Schwartz
1Long Island Jewish Medical Center, Schneider Children's Hospital, New Hyde Park, NY, USA.
Insights
Endorectal pull-through surgery for Hirschsprung
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Hirschsprung's disease is a congenital condition affecting the large intestine.
- Surgical intervention is the primary treatment for Hirschsprung's disease.
Purpose of the Study:
- To evaluate the long-term outcomes of endorectal pull-through surgery for Hirschsprung's disease.
- To assess continence and bowel control in patients treated with endorectal pull-through without colostomy.
Main Methods:
- Retrospective analysis of 84 patients with Hirschsprung's disease treated over 18 years.
- Focus on 43 infants under 1 month who underwent endorectal pull-through without colostomy.
- Follow-up data collected for up to 18 years.
Main Results:
- Of 43 infants, 34 (79%) were available for follow-up.
- Twenty-two (65%) achieved total continence.
- Twelve (35%) had normal sphincter tone.
Conclusions:
- Endorectal pull-through without colostomy is an effective treatment for Hirschsprung's disease in infants.
- High rates of continence and normal bowel control are achievable with this surgical approach.
Methods:
In the past 18 years, the authors have treated 84 patients with Hirschsprung's disease. Of these, 43 patients were under 1 month of age and underwent endorectal pull-through without colostomy. Some have undergone follow-up for as long as 18 years.
Results:
Thirty-four of these 43 (79%) newborn patients were available for follow-up. Twenty-two were totally continent. The remaining 12 have normal sphincter tone. Of the 41 patients above 1 month of age, 34 (83%) were available for follow-up. Some have undergone follow-up for as long as 18 years.
Conclusion:
Twenty-two of this latter group (79%) have normal bowel control.