Background/Purpose: Recently, the transanal 1-stage pullthrough operation has beenwidely used inHirschsprung disease (HD), and it is obviously superior to tr aditional approach in early term for its noninversion. Howe...Background/Purpose: Recently, the transanal 1-stage pullthrough operation has beenwidely used inHirschsprung disease (HD), and it is obviously superior to tr aditional approach in early term for its noninversion. However, the procedure is relatively so new that it makes assessment of the functional outcome and stooli ng patterns difficult. The aim of this study was to evaluate the clinical outcom es of the transanal 1-stage endorectal pull-through operation in the managemen t of rectosigmoid HD. Methods: Fifty-eight children (39 boys and 19 girls) aged 12 months to 13 years (mean, 2 years) who underwent transanal 1-stage endorect al pull-through operation for HD were followed up from 6 to 24 months. Clinical outcome was assessed by interviews and questionnaires. All patients had an agan glionic segment confined to the rectosigmoid area which was confirmed by the pre operative barium enema and postop erative pathological examination. Results: Forty-six patients had satisfactor y results without complications. In all the children, the mean stool times were 1 to 2 per day; only 4 had mean stool times of 8 to 10 per day. Postoperative so iling was present in 9, constipation in 5, and HD-associated enterocolitis in 3 . There were no incontinence, cuff infection, anastomotic leak, and mortality in any of the patients. In the 12 symptomatic patients, there were 4 children with length of aganglionic segment less than 30 cm, and 8 had 30 cm or more. In the 46 asymptomatic patients, 42 had length of aganglionic segment less than 30 cm, and 4 had 30 cm or more. There was a significant difference between the group wi th less than 30 cm and the group with 30 cm or more of aganglionic segment. For statistical analysis, the Fisher exact test showed P < .05. Conclusions: The tra nsanal 1-stage endorectal pull-through is a feasible and safe procedure in chi ldren with rectosigmoid HD. The clinical outcome is satisfactory. A gradual reco very could be noted in the stooling patterns along with the time after surgery. The younger the patient operated on and the shorter the aganglionic segment, the lower do the stooling disorders occur and the faster does the stooling function recover.展开更多
文摘Background/Purpose: Recently, the transanal 1-stage pullthrough operation has beenwidely used inHirschsprung disease (HD), and it is obviously superior to tr aditional approach in early term for its noninversion. However, the procedure is relatively so new that it makes assessment of the functional outcome and stooli ng patterns difficult. The aim of this study was to evaluate the clinical outcom es of the transanal 1-stage endorectal pull-through operation in the managemen t of rectosigmoid HD. Methods: Fifty-eight children (39 boys and 19 girls) aged 12 months to 13 years (mean, 2 years) who underwent transanal 1-stage endorect al pull-through operation for HD were followed up from 6 to 24 months. Clinical outcome was assessed by interviews and questionnaires. All patients had an agan glionic segment confined to the rectosigmoid area which was confirmed by the pre operative barium enema and postop erative pathological examination. Results: Forty-six patients had satisfactor y results without complications. In all the children, the mean stool times were 1 to 2 per day; only 4 had mean stool times of 8 to 10 per day. Postoperative so iling was present in 9, constipation in 5, and HD-associated enterocolitis in 3 . There were no incontinence, cuff infection, anastomotic leak, and mortality in any of the patients. In the 12 symptomatic patients, there were 4 children with length of aganglionic segment less than 30 cm, and 8 had 30 cm or more. In the 46 asymptomatic patients, 42 had length of aganglionic segment less than 30 cm, and 4 had 30 cm or more. There was a significant difference between the group wi th less than 30 cm and the group with 30 cm or more of aganglionic segment. For statistical analysis, the Fisher exact test showed P < .05. Conclusions: The tra nsanal 1-stage endorectal pull-through is a feasible and safe procedure in chi ldren with rectosigmoid HD. The clinical outcome is satisfactory. A gradual reco very could be noted in the stooling patterns along with the time after surgery. The younger the patient operated on and the shorter the aganglionic segment, the lower do the stooling disorders occur and the faster does the stooling function recover.
