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Outcome of single-stage transanal endorectal pull through for short segment Hirschsprung's disease in neonates and infants.
[hirschsprung disease]
Hirschsprung
's
disease
(
HD
)
is
developmental
disorder
of
the
enteric
nervous
system
.
Diagnosis
can
be
confirmed
by
rectal
biopsy
.
The
surgical
management
of
HD
includes
so
many
procedures
.
The
purpose
of
this
study
was
to
evaluate
the
out
come
of
single
-
stage
transanal
endorectal
pull-through
operation
for
short
segment
HD
in
neonates
and
infants
.
This
prospective
study
was
carried
out
in
the
Department
of
Pediatric
Surgery
,
Dhaka
Shishu
(
Children
)
Hospital
,
Dhaka
,
Bangladesh
during
the
period
from
January
2004
to
December
2009
.
The
study
included
neonates
&
infants
(
age
1
day
to
1
year
)
of
both
sex
,
who
were
clinically
suspected
and
biopsy
proven
HD
with
barium
enema
suggesting
rectosigmoid
HD
.
We
excluded
patients
with
short
segment
HD
who
had
associated
anomalies
,
and
with
hugely
dilated
proximal
colon
,
operated
cases
with
less
than
6
months
'
follow
up
.
During
study
period
,
single
-
stage
transanal
endorectal
pull
through
(
TEP
)
operation
done
in
68
neonates
and
infants
patients
(
8
excluded
)
of
short
segment
HD
.
The
mean
operative
time
,
postoperative
hospital
stay
,
followed
up
time
were
120
minutes
,
7
.
94
days
and
12
months
respectively
.
Transeverse
colostomy
was
needed
in
4
patients
because
of
anastomotic
leakage
and
they
were
complicated
with
anastomotic
stenosis
,
however
managed
by
progressive
dilatation
.
Overall
parents
'
satisfaction
was
achieved
.
Single
-
stage
primary
transnanl
endorectal
pull-through
for
short
segment
HD
is
feasible
in
neonates
and
infants
.
It
preserves
all
the
advantages
of
minimally
invasive
surgery
.
TEP
is
a
better
option
in
terms
of
comfort
,
operative
success
,
postoperative
morbidity
,
cosmetic
appearance
and
parents
'
satisfaction
.
Diseases
Validation
Diseases presenting
"minimally invasive surgery"
symptom
cholangiocarcinoma
congenital diaphragmatic hernia
familial hypocalciuric hypercalcemia
hirschsprung disease
inclusion body myositis
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