EN
TÜRKÇE
Oral Presentation - 35
Comparison of Early and Long-Term Outcomes Between LA-TEPT and TEPT in Left-Sided Hirschsprung Disease: Identification of Risk Factors for Postoperative Stricture, Enterocolitis, and Redo Surgery
Mustafa ökten 1, Erol Basuguy 1, Serkan Arslan 1, Mustafa Azizoğlu 2, Bahattin Aydoğdu 3, Mehmet Hanifi Okur 3, Murat Kemal Çiğdem 1
1 Dicle University, Department of Pediatric Surgery, Diyarbakır, Turkey
2 Esenyurt Necmi Kadioglu State Hospital, Dep of Pediatric Surgery, Istinye University, Dep of Stem Cell and Tissue Engineering & 3D Bioprinting, Istanbul, Turkey
3 Department of Pediatric Surgery, Faculty of Medicine Balıkesir Üniversity, Balıkesir, Turkey
Purpose:This study aimed to compare early and long-term outcomes of Laparoscopy-assisted transanal endorectal pull-through (LA-TEPT) and TEPT in left-sided Hirschsprung disease (HD) and identify risk factors for postoperative stricture, postoperative enterocolitis, and redo surgery.
Method:Between January 2010 and September 2024, a total of 151 patients with HD underwent surgery at our clinic. Patients who underwent LA-TEPT or TEPT for left-sided colonic HD were included. Early and long-term outcomes were evaluated.
Results:A total of 75 patients (LA-TEPT:36, TEPT:39) were included. No statistically significant differences were observed between the LA-TEPT and TEPT groups in terms of the following complications: constipation (LA-TEPT:n:14, 38.9%; TEPT:n:14, 35.9%; p:0.789), encopresis (LA-TEPT:n:10, 27.8%; TEPT:n:15, 38.5%; p:0.327), growth retardation (LA-TEPT:n:9, 25%; TEPT:n:7, 17.9%; p:0.456), stricture (LA-TEPT:n:12, 33.3%; TEPT:n:7, 17.9%; p:0.126), dermatitis (LA-TEPT:n:5, 13.9%; TEPT:n:2, 5.1%; p:0.193), enterocolitis (LA-TEPT:n:3, 8.3%; TEPT:n:4, 10.3%; p:0.775), soiling (LA-TEPT:n:4, 11.1%; TEPT:n:6, 15.4%; p:0.586), distension (LA-TEPT:n:2, 5.6%; TEPT:n:2, 5.1%; p:0.978), and the need for redo surgery (LA-TEPT:n:4, 11.1%; TEPT:n:3, 7.7%; p:0.611). In left-sided HD, postoperative stricture (OR:24.5, p:0.032) and growth retardation (OR:18.9, p:0.023) were significant predictors of redo surgery. Postoperative distension (OR:12.8, p:0.021) was significant in univariate but not in multivariate analysis (OR:11.43, p:0.105). Three-stage surgery (OR:3.636, p:0.042) was an independent risk factor; ileus (OR:3.9, p:0.060) showed a borderline association for postoperative stricture formation. Univariate analysis identified ileus (OR:15.6, p:0.004) and three-stage surgery (OR:6.4, p:0.027) as significant risk factors for postoperative enterocolitis.
Conclusions:LA-TEPT and TEPT showed comparable outcomes in left-sided HD. Postoperative stricture, growth retardation, ileus, and three-stage surgery were significant predictors of enterocolitis and need for redo surgery.