Primary Trans-anal Endorectal Pull Through for The Management of Hirschsprung Disease: Our Experience of 20 Cases

Primary Trans-anal Endorectal Pull Through for Hirschsprung Disease

Authors

  • Naveed Haider Haider Department of Pediatric Surgery, D.G. Khan Medical College and DHQ Teaching Hospital D.G. Khan
  • Muhammad Sulman Butt Department of Medicine, RHC Habib Abad PHFMC, Kasur
  • Komal Varda Department of Pediatric Surgery, Akram Medical Complex Lahore, Pakistan
  • Ferheen Shahbaz Department of Public Health, University of the Punjab
  • Maryam Ajaz Department of Public Health, University of the Punjab, Lahore, Pakistan
  • Afeefa Saeed Department of Public Health, University of the Punjab, Lahore, Pakistan
  • Javeria Saleem Department of Public Health, University of the Punjab, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v3i06.332

Keywords:

Hirschsprung’s Disease, Aganglionic Colon, Anastomotic Stricture, Transient Fecal Incontinence

Abstract

Hirschsprung’s disease can be defined in terms of the aganglionic part of the colon and the definitive treatment is a one-stage trans-anal endorectal pull-through surgery.  Objectives: To find out the efficacy and safety of this one-stage pull-through. Mostly the surgery is done in early childhood or the neonatal period, as the case is less frequently reported in older children and adolescents. Methods: A retrospective study was conducted including 16 males and 4 females. 20 cases including children of 6 months to 14 years, all were diagnosed with Hirschsprung’s disease in the study duration of two years. The diagnostic criteria of these patients included; Clinical history of delayed passage of meconium, contrast enema, and rectal biopsy. Definitive variables were; Age, sex, and length of the aganglionic part of the colon. Results: All the patients included in the study had distended abdomens and persistent constipation. All of them have an aganglionic colon, a diagnosing feature of Hirschsprung’s disease. All patients underwent the trans-anal endorectal one-stage pull-through. The average operative time recorded was 150 minutes. Post-operative complications were also recorded including anastomosis leakage (only in one case; for that a diversion colostomy was done), anastomotic stenosis or stricture (not reported in any case), enterocolitis and perineum irritation (In four cases), Transient fecal incontinence is a major complication (11 cases had transient fecal incontinence which resolved spontaneously with 1 to 2 weeks). No death had been recorded. Conclusion: For the treatment of Hirschsprung’s disease, primary trans-anal endorectal pull-through is a safe and efficient technique.

 

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Published

2022-11-30
CITATION
DOI: 10.54393/pjhs.v3i06.332
Published: 2022-11-30

How to Cite

Haider, N. H., Sulman Butt, M. ., Varda, K. ., Shahbaz , F. ., Ajaz, M. ., Saeed, A. ., & Saleem, J. . (2022). Primary Trans-anal Endorectal Pull Through for The Management of Hirschsprung Disease: Our Experience of 20 Cases: Primary Trans-anal Endorectal Pull Through for Hirschsprung Disease. Pakistan Journal of Health Sciences, 3(06), 129–134. https://doi.org/10.54393/pjhs.v3i06.332

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