A 15-Year Experience with the One-Stage Surgery for Treatment of Hirschsprung's Disease in Newborns, Infants, and Young Children

Indian J Surg. 2015 Dec;77(Suppl 3):1109-14. doi: 10.1007/s12262-014-1186-3. Epub 2014 Oct 31.

Abstract

The treatment of Hirschsprung's disease has changed over the past several years. Significant modifications occurred after the implementation of surgery without laparotomy, using transanal access. The type of this surgery depends on the condition and the age of a child. The aim of the study was to summarize our 15-year experience with one-stage surgery for the treatment of Hirschsprung's disease in the wider context of current clinical practice and to identify transanal endorectal pull-through-related factors influencing the surgery and hospitalization. The retrospective analysis of newborns, infants, and young children was performed between 2000 and 2014. Four girls and 29 boys were operated on. The parameters describing the surgery and the hospitalization were analyzed. The number of patients treated using transanal endorectal pull-through technique was 30, and Duhamel-Martin, 3. There were significant correlations (p < 0.05) between necessity of blood transfusion, length of resected intestine, operative time, the number of intraoperative histopathological assessments, and length of hospitalization. The time of one-step surgery is extended because of waiting for repeated intraoperative histopathological assessment of the level of resection. More extended bowel resection is connected with longer length of hospitalization and, more often, necessity of blood transfusion.

Keywords: Child; Congenital intestinal aganglionosis; Hirschsprung’s disease; Surgical procedures.