短腸管ヒルシュスプルング病に対する凍結切片を用いない一期的経肛門的スвенソン・プルースルー術の成績
1, Abdul Rehman Rashid2, Muhammad Amir Hanif1
1Department of Paediatric Surgery, Nishtar Medical University, Nishtar Hospital, Multan, Pakistan.
Objectives:
To evaluate the outcome of single-stage transanal Swenson pull-through without frozen section in paediatric patients with short-segment Hirschsprung's disease.
Methods:
The single-group, prospective, cohort study was conducted at the Paediatric Surgical Unit, Nishtar Medical University, Multan, Pakistan, from January 2020 to December 2022 and comprised patients aged 1-12 years who were confirmed to have Hirschsprung's disease through rectal biopsy and demonstrated short-segment involvement on contrast enema. Single-stage transanal Swenson's pull-through procedure was performed on all patients without the use of frozen sections. Postoperative follow-up lasted 6 months. Data was analysed using SPSS 25.
Results:
Of the 97 patients, 64(66%) were boys and 33(34%) were girls. The overall mean age was 2.97±1.62 years. Complications were observed in 21(21.65%) patients, with anastomotic stricture being the most common 6(6.19%), followed by increased stool frequency 5(5.15%), enterocolitis 5(5.15%), and anastomotic leakage 3(3.09%). Biopsy of the excised segment revealed that 2(2.06%) pagtients had aganglionic bowel pull-through.
Conclusions:
The single-stage transanal pull-through, when performed in the absence of frozen section, was found to be safe in the management of short-segment Hirschsprung's disease.
