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Surgical outcomes of total colonic aganglionosis in children: A 26-year experience in a single institute.
[hirschsprung disease]
There
is
a
lack
of
consensus
regarding
the
treatment
of
total
colonic
aganglionosis
(
TCA
)
with
respect
to
perioperative
morbidity
,
mortality
,
complications
,
and
functional
outcomes
.
The
aim
of
this
study
was
to
review
the
results
of
surgical
TCA
treatment
over
a
26
-
year
period
and
characterize
the
outcomes
.
We
retrospectively
reviewed
the
clinical
characteristics
,
surgical
courses
,
and
outcomes
of
TCA
patients
who
underwent
definitive
pull-through
operations
from
1986
to
2012
.
Follow-up
data
were
collected
by
chart
reviews
and
telephone
interviews
using
a
standardized
questionnaire
.
We
identified
nine
infants
with
TCA
(
8
.
6
%
)
from
among
105
infants
with
Hirschsprung
's
disease
treated
during
the
26
-
year
period
.
Neither
sex
predominated
(
male
/
female
ratio
Â
=
Â
4
:
5
)
.
All
infants
underwent
laparotomies
and
simultaneous
enterostomies
.
All
patients
eventually
underwent
modified
Duhamel
pull-through
procedures
at
a
mean
age
of
179
Â
days
(
range
,
47
-
352
Â
days
)
.
Two
infants
died
of
complications
after
surgery
including
heart
failure
and
sepsis
.
The
remaining
infants
recovered
smoothly
with
antilaxative
medications
,
and
all
but
one
was
weaned
off
these
medications
.
Although
the
surviving
patients
did
not
catch
up
on
growth
,
they
and
their
families
were
satisfied
with
the
surgical
results
.
Infants
with
TCA
had
satisfactory
outcomes
after
the
modified
Duhamel
pull-through
operation
.
Based
on
our
experience
,
we
suggest
that
the
pull-through
operation
could
be
performed
earlier
,
even
when
there
are
loose
stools
from
the
enterostomy
.
Diseases
Validation
Diseases presenting
"female ratio "
symptom
hirschsprung disease
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