29. National Pediatric Surgery Congress and 27. National Congress of The Egyptian Pediatric Surgical Association

View Abstract

Oral Presentation - 43

Transanal Endorectal Pull-through for Hirschsprung's Disease During the First Month of Life.

Transanal Endorectal Pull-through for Hirschsprung's Disease During the First Month of Life.

 

Kamal Abd El-Elah Aly,MD.

Pediatric surgery unit, Department of Surgery, Faculty of Medicine,Mansoura university, Egypt

 

 

Abstract:

Background/Purpose:Hirschsprung's disease  (HD)  is a  common cause of  bowel obstruction in the newborn period. One-stage surgery for HD is well established and the results are comparable or better than multistage surgery. The aim of this study was to test the feasibility  and safety  of  transanal endorectal pull-through (TEPT)  for management of HD during the neonatal period.

 

Patients and Methods:28 neonates having  HD  were  treated with TEPT at pediatric surgery  unit, Mansoura  University  Children's Hospital (MUCH)  during  the period from May 2007 to Jun 2009. Six cases were in need for concomitant laparotomy due to long  segment disease. Endorectal mucosectomy  was started one  cm.  above  dentate line and continued till the peritoneal reflection. The affected bowel was resected and colo-anal anastomosis was performed with 4/0 absorbable sutures.

 

Results:The  mean operative  time was 90±18 minutes. Blood transfusion was not needed. Oral feeding started 24-48 hours postoperatively and the mean hospital stay was 3-5 days. The commonest postoperative  complication was perianal excoriations (64.3%),  anastomotic  leak occurred in one  case. Two cases were  in need for  repeated dilatations while 4 cases presented with postoperative enterocolitis (EC).

 

Conclusion: TEPT during the neonatal period is easy, bloodless, without visible scar and with short intraoperative time and postoperative hospital stay.

 

Index Words:Hirschsprung's disease, transanal endorectal pull-through, neonates.


 

 


 

 

Transanal Endorectal Pull-through for Hirschsprung's Disease During the First Month of Life.

 Transanal Endorectal Pull-through for Hirschsprung's Disease During the First Month of Life.

 

Kamal Abd El-Elah Aly,MD.

Pediatric surgery unit, Department of Surgery, Faculty of Medicine,Mansoura university, Egypt

 

 

Abstract:

Background/Purpose:Hirschsprung's disease  (HD)  is a  common cause of  bowel obstruction in the newborn period. One-stage surgery for HD is well established and the results are comparable or better than multistage surgery. The aim of this study was to test the feasibility  and safety  of  transanal endorectal pull-through (TEPT)  for management of HD during the neonatal period.

 

Patients and Methods:28 neonates having  HD  were  treated with TEPT at pediatric surgery  unit, Mansoura  University  Children's Hospital (MUCH)  during  the period from May 2007 to Jun 2009. Six cases were in need for concomitant laparotomy due to long  segment disease. Endorectal mucosectomy  was started one  cm.  above  dentate line and continued till the peritoneal reflection. The affected bowel was resected and colo-anal anastomosis was performed with 4/0 absorbable sutures.

 

Results:The  mean operative  time was 90±18 minutes. Blood transfusion was not needed. Oral feeding started 24-48 hours postoperatively and the mean hospital stay was 3-5 days. The commonest postoperative  complication was perianal excoriations (64.3%),  anastomotic  leak occurred in one  case. Two cases were  in need for  repeated dilatations while 4 cases presented with postoperative enterocolitis (EC).

 

Conclusion: TEPT during the neonatal period is easy, bloodless, without visible scar and with short intraoperative time and postoperative hospital stay.

 

Index Words:Hirschsprung's disease, transanal endorectal pull-through, neonates.


 

 


 

  

Close