Transanal endorectal vs. Duhamel pull-through for Hirschsprung's disease.
BACKGROUND
The aim of this study was to test the hypothesis that the early functional outcome for patients with rectosigmoid Hirschsprung's disease (HD) is comparable for the Duhamel pull-through procedure and the transanal endorectal pull-through (TERPT) procedure, with less discomfort for the patient postoperatively after the TERPT technique.


METHODS
Eleven patients operated on with the TERPT technique (T Group) were prospectively registered and compared retrospectively with 18 patients operated on with the Duhamel pull-through (D Group). Data recorded included patient demographics, operative treatment, complications, hospital stay and bowel functions. The follow-up time was limited to 24 months.


RESULTS
The T Group started oral feeding sooner, their bowel movements started sooner and they had less need for analgesia postoperatively and a significantly shorter hospital stay. 71% of the patients in the D Group needed re-intervention compared to only 18% of the T Group. Enterocolitis was seen in two patients in both groups. At the last clinical control ten patients had constipation (59%) and three had soiling (18%) in the D Group. Three patients in the T Group had constipation (27%) and one had soiling (9%).


CONCLUSIONS
Our results support the use of the TERPT method rather than the Duhamel pull-through for rectosigmoid HD.
Gunnarsdóttir
A
A
Lund University Hospital, Department of Pediatric Surgery, Lund, Sweden. anna.gunnarsdottir@med.lu.se
Larsson
L-T
LT
Arnbjörnsson
E
E
D001003:Anal Canal / Q000601:surgery*; D002675:Child, Preschool; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006627:Hirschsprung Disease / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome