title: Laparoscopic relief of obstructing folded muscular cuff after transanal pull-through for aganglionosis.
abstract: Transanal endorectal resection and colonic pull-through (TERPT) is a good technique for the management of Hirschsprung's disease. This procedure is feasible in the vast majority of patients and is associated with excellent results, early postoperative recovery, and no visible scars. We report the case of a patient who developed early postoperative severe constipation after TERPT due to unusual folding of the muscular cuff rim, which tightly narrowed the pulled-through colon. This complication was diagnosed and treated by laparoscopy. To prevent it, we recommend splitting of the aganglionic muscular cuff during TERPT.
authors.affiliation: Department of Pediatric Surgery, Spedali Civili, Piazza Spedali Civili 1, 25100 Brescia, Italy. diego.f@ciaoweb.it
authors.forename: D
authors.initials: D
authors.lastname: Falchetti
authors.forename: A
authors.initials: A
authors.lastname: Dessanti
authors.forename: V
authors.initials: V
authors.lastname: Villanacci
authors.forename: M
authors.initials: M
authors.lastname: Iannuccelli
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects; D003248:Constipation / Q000209:etiology / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D012086:Reoperation