title: [Transanal resection of colon for Hirschsprung's disease].
abstract: BACKGROUND
  Traditional surgical management of Hirschsprung's disease consists of a three-stage approach including proximal colostomy, definitive pull-through resection at one year of age and closure of the stoma shortly after the pull-through. At our institution, patients with this disorder have been operated with a one-stage transanal technique without laparotomy and colostomy since 2001. The early results of this procedure are presented in the article.
  
  
  METHODS
  Complications and postoperative bowel function have been recorded after the introduction of the one-stage transanal technique.
  
  
  RESULTS
  Transanal pull-through was intended in 20 children. Laparotomy (5 patients) and laparoscopy (1 patient) were done in 6 of the children due to technical reasons. Median weight at operation was five kg (3.5-25 kg), and a median of 25 cm of bowel (9-36 cm) were resected transanally. There were no perioperative complications. Postoperative complications included stricture (3 patients), perianal excoriations (2 patients) and severe constipation (1 patient). Short term follow up shows similar bowel habits as after laparotomy procedures.
  
  
  CONCLUSIONS
  Early results show that primary transanal pull-through in Hirschsprung's disease patients with aganglionosis to descending colon is safe. It is beneficial to avoid a colostomy and probably laparotomy.
authors.affiliation: Kirurgisk avdeling, Rikshospitalet og Forskerlinjen Universitetet i Oslo.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Rehman
authors.forename: Ragnhild
authors.initials: R
authors.lastname: Emblem
authors.forename: Kristin
authors.initials: K
authors.lastname: Bjørnland
mesh_terms: D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000601:surgery*; D003125:Colostomy; D003672:Defecation; D005500:Follow-Up Studies; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis; D016896:Treatment Outcome