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Surgical treatment for Hirschsprung disease (HD) has evolved from a staged repair to a primary operation but is still associated with significant complications. Extensive transanal dissection may overstretch the sphincter and cause partial tear; however, laparoscopic dissection can decrease rectal overstretching. Thus, this study aimed to evaluate the outcome of surgical management of HD and the efficacy of laparoscopic-assisted transanal endorectal pull-through in infants and children in our center. We reviewed the medical records of 74 patients who underwent surgical repair of HD from 2006 to 2019. However, we excluded 42 patients with HD (patients with stoma [ = 33] and total colonic aganglionosis [ = 9]). The remaining 32 patients were divided into two groups. Group A included patients who had transanal pull-through with laparoscopic assistance only to visualize the transition zone, take a biopsy, and check for twisting or bleeding. Group B included patients who had laparoscopic-assisted transanal pull-through with dissection of the rectum. All patients had Soave repair with an approximate cuff length of 5 cm. Group A included 18 patients, whereas group B included 14 patients. Demographic data were comparable between the two groups with no significant difference in age or gender ( = .12 and .67, respectively). Patients in group A had longer operative time (210 ± 20.75 minutes versus 178 ± 18.92 minutes; < .001) and hospital stay (6 ± 1.33 days versus 5 ± 1.24 days; = .033). No significant difference was observed in postoperative complications between both groups (anastomotic site stricture, = .295; persistent soiling, = .238). Laparoscopic rectal dissection for managing HD is associated with less operative time and hospital stay. In addition, all procedures required for the repair can be safely performed using laparoscopy.
This article was published in the following journal.
Name: Journal of laparoendoscopic & advanced surgical techniques. Part A
Retrospective and descriptive study of patients with diagnosis of Hirschsprung disease (HD) in whom transanal pull-through was performed in our center.
Surgical treatment of Hirschsprung disease (HD) evolved in the last decades with the introduction of new innovative minimally invasive techniques. The aim of present study is to compare the results fr...
Although most children with Hirschsprung disease ultimately achieve functional and comfortable stooling, some will experience a variety of problems after pull-through surgery. The most common problems...
Rectal cancer located in distal third still remains a technical challenge for surgeons. Transanal total mesorectal excision with laparoscopic assistance is quite new surgical approach for rectal cance...
Hirschsprung disease is a genetic condition caused by lack of nerve cells in varying lengths of the intestines. This study will investigate the complex genetic basis of the disease, which ...
Anorectal malformations are congenital malformations, in which the terminal part of the hindgut is abnormally placed and lies outside (partially or completely) the sphincter mechanism.
This study aims to compare the outcomes of patients with long segment Hirschsprung disease or total colonic aganglionosis who had negative calretinin staining and positive ganglion cells o...
At present, surgical resection is still the main treatment for the potential cure of rectal cancer. Total mesorectal excision (TME) is the gold standard. The traditional laparoscopic or op...
This study is designed as a prospective, multi-center, randomized, open-labelled, parallel group, non-inferiority trial. The aim of this study is to evaluate the TaTME technique compared w...
Placement of one of the surgeon's gloved hands into the ABDOMINAL CAVITY to perform manual manipulations that facilitate the laparoscopic procedures.
A specialized form of transanal endoscopic surgery for microscopically controlled operations in the RECTUM.
Surgical procedures conducted with the aid of computers. This is most frequently used in orthopedic and laparoscopic surgery for implant placement and instrument guidance. Image-guided surgery interactively combines prior CT scans or MRI images with real-time video.
The pull on a limb or a part thereof. Skin traction (indirect traction) is applied by using a bandage to pull on the skin and fascia where light traction is required. Skeletal traction (direct traction), however, uses pins or wires inserted through bone and is attached to weights, pulleys, and ropes. (From Blauvelt & Nelson, A Manual of Orthopaedic Terminology, 5th ed)
A technique that came into use in the mid-1980's for assisted conception in infertile women with normal fallopian tubes. The protocol consists of hormonal stimulation of the ovaries, followed by laparoscopic follicular aspiration of oocytes, and then the transfer of sperm and oocytes by catheterization into the fallopian tubes.
Surgery is a technology consisting of a physical intervention on tissues. All forms of surgery are considered invasive procedures; so-called "noninvasive surgery" usually refers to an excision that does not penetrate the structure being exci...
Pediatrics is the general medicine of childhood. Because of the developmental processes (psychological and physical) of childhood, the involvement of parents, and the social management of conditions at home and at school, pediatrics is a specialty. With ...