Rare Diseases Symptoms Automatic Extraction
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Redo pullthrough for Hirschsprung disease: a single surgical group's experience.
[hirschsprung disease]
This
study
presents
our
surgical
experience
for
redo-pullthrough
(
RedoPT
)
for
Hirschsprung
disease
(
HD
)
.
It
reviews
the
patient
's
clinical
outcomes
and
assesses
stooling
patterns
after
RedoPT
.
A
retrospective
review
of
our
institution
's
RedoPTs
as
well
as
one
author
's
overseas
cases
was
performed
.
Stooling
scores
were
tabulated
using
an
established
survey
tool
and
compared
to
primary
PT
matched
patients
.
Between
1974
and
2012
,
46
individuals
(
52
%
males
)
underwent
RedoPT
,
representing
3
percent
of
all
HD
pullthroughs
.
Median
age
at
primary
PT
and
RedoPT
was
1
year
(
range
1
week
-
18
years
)
and
3
.
5
years
(
range
8
weeks
-
41
years
)
,
respectively
.
Indications
for
RedoPT
were
predominately
for
aganglionosis
/
transition
zone
pathology
(
71
%
)
;
followed
by
stricture
or
an
obstructing
Duhamel
pouch
(
19
%
)
,
tight
cuff
(
8
%
)
and
a
twisted
PT
(
4
%
)
.
None
were
performed
for
an
isolated
clinical
diagnosis
of
repeated
bouts
of
enterocolitis
.
RedoPT
surgical
approach
depended
upon
the
initial
pullthrough
technique
and
any
previous
complications
.
Stooling
scores
were
significantly
(
P
<
0
.
05
)
worse
in
the
RedoPT
patients
compared
to
the
historically-matched
group
of
children
undergoing
a
primary
PT
for
HD
(
5
.
5
±
1
.
2
vs
.
12
.
2
±
1
.
4
,
primary
PT
versus
RedoPT
,
respectively
)
.
When
breaking
down
this
total
score
into
individual
parameters
,
stooling
pattern
scores
(
1
.
0
±
0
.
2
vs
.
4
.
1
±
0
.
4
,
P
=
0
.
001
)
and
enterocolitis
scores
(
2
.
0
±
0
.
4
vs
.
4
.
2
±
0
.
4
,
P
=
0
.
001
)
were
statistically
worse
in
the
RedoPT
group
.
Patients
in
both
groups
had
similar
overall
continence
rates
.
Appropriately
selected
children
undergoing
a
RedoPT
can
achieve
good
results
,
with
comparable
continence
rates
to
those
undergoing
a
primary
PT
.
Diseases
Validation
Diseases presenting
"enterocolitis"
symptom
congenital diaphragmatic hernia
hirschsprung disease
megacystis-microcolon-intestinal hypoperistalsis syndrome
omenn syndrome
phenylketonuria
sneddon syndrome
This symptom has already been validated
