WOFAPS 2025 8th World Congress of Pediatric Surgery

Avazjon Dekhkonboev ¹, Viktoriya Kholostova ², Makhmudjan Aliev ³, Akmal Akhmadjonov ¹, Rustam Yuldashev ¹, Abdulaziz Tadjibaev ¹

¹ Republican specialized scientific practical medical center of pediatrics
² Pirogov Russian National Research Medical University
³ Tashkent state medical university

Introduction. Permanent stoma (PS) represents one of the most unfavorable outcomes in the treatment of Hirschsprung’s disease (HD), irreversibly depriving patients of the ability to achieve physiological defecation. This article analyzes both original and literature data regarding the causes of PS.

Materials and Methods. A retrospective analysis was conducted on 367 patients with HD treated between 2016 and 2024. Most children had previously undergone radical surgery in various clinics, predominantly using the Soave-Georgeson technique. Among them, PS was ultimately required in 8 cases. The main indications for permanent stoma formation included long-standing, recurrent complications such as perianal abscesses (7 cases), perineal fistulas (5), fecal incontinence (6), and rectal stenosis (2). Three patients had syndromic forms of HD, and total colonic aganglionosis (TCA) was diagnosed in 5 cases.

Results. TCA was associated with a significantly higher risk of developing PS (p = 0.002). Delayed access to specialized surgical care substantially increased the likelihood of PS (p = 0.023). All patients with PS (100%) were diagnosed with anastomotic insufficiency at the colorectal junction.