Complications of Transanal One-stage Endorectal Pull-through Procedure in Infants with Hirschsprung's Disease
Introduction: Hirschsprung's disease(HD) is a common congenital disease. In 80% of cases, the recto sigmoid junction is involved. Recently, one-stage transanal endorectal pull-through(TAEPT) procedure has been popular, but it could have several complications. In this research, we have studied t...
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Shahid Sadoughi University of Medical Sciences
2011-08-01
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doaj-1c50da57755748af9844bb1484e6dd912020-11-25T01:10:23ZfasShahid Sadoughi University of Medical SciencesMajallah-i Dānishgāh-i ’Ulūm-i Pizishkī-i Shahīd Ṣadūqī Yazd2228-57412228-57332011-08-01193350358Complications of Transanal One-stage Endorectal Pull-through Procedure in Infants with Hirschsprung's DiseaseM RouzrokhA JalaliM SamsamiH ZirakzadehA HeidariM FallahZ YektaIntroduction: Hirschsprung's disease(HD) is a common congenital disease. In 80% of cases, the recto sigmoid junction is involved. Recently, one-stage transanal endorectal pull-through(TAEPT) procedure has been popular, but it could have several complications. In this research, we have studied the complications of this procedure. Methods: During a four year period, 86 infants clinically suspected to have HD were admitted at our center. HD was confirmed by rectal biopsy and all were candidates for TAEPT operation. A Swenson-like procedure was performed and in 30 cases, prophylactic Hegar dilatation was done 2 weeks after operation. Results: Anal stricture was seen in 12 cases(14%) of which 10 cases were treated by anal dilation and 2 cases were corrected by surgical management. Entrocolitis was seen in 4 cases(5%) who were treated by medical management. In 2 cases, retrocolic abscess was present that was treated by spontaneous drainage via tube drain. There was no anastomotic stricture after starting prophylactic anal bouginage. Conclusion: TAEPT has many advantages and few complications. It seems that one of the most common complications is anastomotic stricture that responds well to prophylactic bouginage. We recommend prophylactic anal bouginage with Hegar probe 2 weeks after operation. A long-term follow-up is needed to evaluate the outcomes of these operations.http://85.185.157.11:6280/jssu/browse.php?a_id=1573&slc_lang=en&sid=1&ftxt=1Hirschsprung DiseaseInfantAnastomosisSurgicalColectomyTreatment OutcomeProspective Complications |
collection |
DOAJ |
language |
fas |
format |
Article |
sources |
DOAJ |
author |
M Rouzrokh A Jalali M Samsami H Zirakzadeh A Heidari M Fallah Z Yekta |
spellingShingle |
M Rouzrokh A Jalali M Samsami H Zirakzadeh A Heidari M Fallah Z Yekta Complications of Transanal One-stage Endorectal Pull-through Procedure in Infants with Hirschsprung's Disease Majallah-i Dānishgāh-i ’Ulūm-i Pizishkī-i Shahīd Ṣadūqī Yazd Hirschsprung Disease Infant Anastomosis Surgical Colectomy Treatment Outcome Prospective Complications |
author_facet |
M Rouzrokh A Jalali M Samsami H Zirakzadeh A Heidari M Fallah Z Yekta |
author_sort |
M Rouzrokh |
title |
Complications of Transanal One-stage Endorectal Pull-through Procedure in Infants with Hirschsprung's Disease |
title_short |
Complications of Transanal One-stage Endorectal Pull-through Procedure in Infants with Hirschsprung's Disease |
title_full |
Complications of Transanal One-stage Endorectal Pull-through Procedure in Infants with Hirschsprung's Disease |
title_fullStr |
Complications of Transanal One-stage Endorectal Pull-through Procedure in Infants with Hirschsprung's Disease |
title_full_unstemmed |
Complications of Transanal One-stage Endorectal Pull-through Procedure in Infants with Hirschsprung's Disease |
title_sort |
complications of transanal one-stage endorectal pull-through procedure in infants with hirschsprung's disease |
publisher |
Shahid Sadoughi University of Medical Sciences |
series |
Majallah-i Dānishgāh-i ’Ulūm-i Pizishkī-i Shahīd Ṣadūqī Yazd |
issn |
2228-5741 2228-5733 |
publishDate |
2011-08-01 |
description |
Introduction: Hirschsprung's disease(HD) is a common congenital disease. In 80% of cases, the recto sigmoid junction is involved. Recently, one-stage transanal endorectal pull-through(TAEPT) procedure has been popular, but it could have several complications. In this research, we have studied the complications of this procedure. Methods: During a four year period, 86 infants clinically suspected to have HD were admitted at our center. HD was confirmed by rectal biopsy and all were candidates for TAEPT operation. A Swenson-like procedure was performed and in 30 cases, prophylactic Hegar dilatation was done 2 weeks after operation. Results: Anal stricture was seen in 12 cases(14%) of which 10 cases were treated by anal dilation and 2 cases were corrected by surgical management. Entrocolitis was seen in 4 cases(5%) who were treated by medical management. In 2 cases, retrocolic abscess was present that was treated by spontaneous drainage via tube drain. There was no anastomotic stricture after starting prophylactic anal bouginage. Conclusion: TAEPT has many advantages and few complications. It seems that one of the most common complications is anastomotic stricture that responds well to prophylactic bouginage. We recommend prophylactic anal bouginage with Hegar probe 2 weeks after operation. A long-term follow-up is needed to evaluate the outcomes of these operations. |
topic |
Hirschsprung Disease Infant Anastomosis Surgical Colectomy Treatment Outcome Prospective Complications |
url |
http://85.185.157.11:6280/jssu/browse.php?a_id=1573&slc_lang=en&sid=1&ftxt=1 |
work_keys_str_mv |
AT mrouzrokh complicationsoftransanalonestageendorectalpullthroughprocedureininfantswithhirschsprungsdisease AT ajalali complicationsoftransanalonestageendorectalpullthroughprocedureininfantswithhirschsprungsdisease AT msamsami complicationsoftransanalonestageendorectalpullthroughprocedureininfantswithhirschsprungsdisease AT hzirakzadeh complicationsoftransanalonestageendorectalpullthroughprocedureininfantswithhirschsprungsdisease AT aheidari complicationsoftransanalonestageendorectalpullthroughprocedureininfantswithhirschsprungsdisease AT mfallah complicationsoftransanalonestageendorectalpullthroughprocedureininfantswithhirschsprungsdisease AT zyekta complicationsoftransanalonestageendorectalpullthroughprocedureininfantswithhirschsprungsdisease |
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