Results of the Treatment of Hirschsprung’s Disease: Comparison between Transabdominal and Transanal Endorectal Pull-through Operations

Authors

  • Montinee Supchatura Department of Surgery, Queen Sirikit National Institute of Child Health
  • Veera Buranakitjaroen Department of Surgery, Queen Sirikit National Institute of Child Health
  • Narong Nithipanya Department of Radiology, Queen Sirikit National Institute of Child Health
  • Varaporn Mahatharadol Department of Surgery, Queen Sirikit National Institute of Child Health
  • Rangsan Niramis Department of Surgery, Queen Sirikit National Institute of Child Health

Keywords:

Hirschsprung’s disease, abdominal pull-through operation, transanal endorectal pull-through, operation, results of treatment, enterocolitis, constipation

Abstract

Background: Transabdominal pull-through operation has been established as the definitive treatment of Hirschsprung’s disease (HD) since 1948. One-stage transanal endorectal pull-through procedure is the latest evolution in the management of HD.

Objective: The aim of this study was to review the results of the treatment of HD by comparing between transabdomial and transanal endorectal pull-through operations.

Materials and Methods: Medical records of patients with HD who underwent definitive treatment between January 2007 and December 2012 at Queen Sirikit National Institute of Child Health were retrospectively reviewed. Patients who underwent transabdominal and transanal endorectal pull-through operations were categorized into groups A and B, respectively.

Results: of the two groups were compared using the Chi-square test, and a p-value less than 0.05 was considered statistically significant. Results: Of the 145 patients with HD, 86 (59%) were treated by transbdominal pull-through operation (group A), and 59 (41%) were treated by transanal pull-through procedure (group B). Age at operation ranged from 1.6 months to 12.7 years in group A and 21 days to 5.6 years in group B. One year after operation, normal defecation and continence were noted in 71% of patients in group A, and 70% in group B (p = 0.925). Constipation was more common in group A than that in group B (15% vs. 7%; p = 0.032). Anastomotic leakage (4%) and adhesive small bowel obstruction (4%) occurred in group A, but did not occur in group B. Only anastomotic stricture which required anal dilatation was more common in group B than that in group A, but with no statistical significance (9% vs. 4%; p = 0.267). The incidence of postoperative enterocolitis was not different between groups A (20%) and B (20%). There was no immediate postoperative death in both groups.

Conclusions: Operative outcomes from the present study revealed that transanal endorectal pull-through operation was better than the transabdominal procedure in terms of the low incidence of constipation, anastomotic leakage, postoperative small bowel obstruction and constipation. Occurrence of normal defecation and the incidence of postoperative enterocolitis were not different between the two techniques.

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Published

2016-03-31

How to Cite

1.
Supchatura M, Buranakitjaroen V, Nithipanya N, Mahatharadol V, Niramis R. Results of the Treatment of Hirschsprung’s Disease: Comparison between Transabdominal and Transanal Endorectal Pull-through Operations. Thai J Surg [Internet]. 2016 Mar. 31 [cited 2024 Dec. 23];37(1):6-11. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/219973

Issue

Vol. 37 No. 1 (2016): January - March

Section

Original Articles

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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.