One-stage transanal Swenson procedure for rectosigmoid Hirschsprung's disease in infants and children. Issue 3 (July 2016)

• Record Type: Journal Article
• Authors: Al-Baghdady, Ayman A.; El-Shafei, Ehab A.; El-Asmar, Khaled M.
• Is Part Of: Annals of pediatric surgery. Volume 12:Issue 3(2016)
• Publication Date: 2016-07
• Subjects: Children -- Surgery -- Periodicals; Pediatrics -- Periodicals; Surgical Procedures, Operative -- Periodicals; Pediatrics -- Periodicals; Children -- Surgery; Pediatrics; Periodicals; 617.98005
• DOI: 10.1097/01.XPS.0000482859.77300.04
• Languages: English
• ISSNs: 2090-5394

Abstract

Abstract : Objective: This study aimed to present the outcome of transanal one-stage Swenson pull-through procedure in the management of rectosigmoid Hirschsprung's disease (HD). Background: HD is a common cause of intestinal obstruction in pediatric age. Several pull-through procedures have been used to treat this pathology. Patients and methods: Between June 2008 and June 2015, 84 children with biopsy-proven HD underwent transanal one-stage Swenson pull-through procedure. Intraoperative details, postoperative complications, and bowel habits were recorded. Follow-up period ranged from 6 to 42 months. Results: The age at the time of surgery ranged from 3 months to 2 years. The length of the resected aganglionic segment ranged from 12 to 34 cm. The operating time ranged from 72 to 180 min. Postoperative hospital stay ranged from 3 to 6 days. There were no anastomotic leaks, no perianal infection, or postoperative bowel obstruction. Twelve patients (14.28%) developed postoperative enterocolitis. Six patients (7.14%) required a posterior internal sphincter myectomy despite repeated dilatations. All patients had less than four times bowel motions per day, 3 months after surgery. No voiding disturbances were encountered at the end of the follow-up period and none of the patients complained of recurrent constipation. Six patients developed perianal dermatitis, which was treated conservatively within 3 months after surgery. Anastomotic circumference could not be felt at digital examination in 78 patients 3 months after surgery. Conclusion: One-stage transanal Swenson pull-through procedure is a safe alternative and simpler procedure for rectosigmoid HD with low morbidities and accepted outcome as regards postoperative bowel habits.