Evaluation of one-Stage Transanal Endorectal Pull-Through(TERPT) Technique on Defecation in Patients with Hirschsprung Disease over Last 10 Years in TEHRAN PEDIATRICS MEDICAL CENTER

Maryam Ghavami Adel--- Associate Professor, Pediatric surgeon, Tehran University of Medical Science, Tehran,
Bahar Ashjaei--- Pediatric surgeon, Tehran University of Medical Science, Tehran,
Sima Sinafar--- Anesthesiology, Tehran University of Medical Science, Tehran,
Jaleh Parizad--- Head Nurse, Department of Gastroenterology, Children's Medical Center, Tehran University of Medical Sciences,
Leili Maghbouli--- Pediatric Resident, Zanjan University of Medical Science, Zanjan,
Rahman Khosravi--- Children's Medical Center, Tehran University of Medical Sciences,
Behdad Gharib---



One of the suggested methods for the treatment of Hirschprung disease is  of Evaluation of one-stage Tran's anal Endo rectal pull-through (TERPT).The purpose of this study is to evaluate the status of deification and complications of surgery in patients undergoing pull-through surgery in THERAN pediatrics Medical center during past 10 years.

Materials & methods:

This descriptive study was performed on patients undergoing one-stage Transanal Endo rectal pull-through operation in Tehran pediatrics Medical center over  past 10 years.

Exclusion Criteria include the parent's lack of consent to participate in the study, age below 3 years, and inability to complete the checklist. For all patients, a check list including: Age/ family history of disease/ readmission/ age / Follow-up time/ presence of soiling/ complete & partial fecal incontinence/ constipation/ laxative use/ use of Boogie/ the presence & absence of RAIR in manometers, TR stricture and enterocolitis before & after surgery, Was gathered. Data analysis was performed using spss 19.


4.81% of the subjects were male. 3.9% of them had underlying disease, such as heart & kidney disease. And only 6.81% of them had to be re-admitted because of enterocolitis.  5.39% of patients had soiling, and complete & partial fecal incontinence were 3.2% and 7.4% .respectively total incidence of fecal incontinency was 7%. 6.11% of cases had constipation. 3/9% of cases did not have RAIR in manometery.the incidence of rectal stenosis was 7%. 93%of patients had TZ in barium enema befor the operation. The result showed that there was no significant relationship between post- operative complications in both sexes. (o5<Op)

DISCUSSION & Conclusion:

This study shows that the complications of Endo rectal Trans anal pull-through surgery as a method for treatment of Hirschsprung disease are infrequent, therefore this method can be considered as a selective method. Further investigations are recommended to prove the hypothesis.


Hirsch sprung; Trans anal; Endo rectal; pull-through; Soiling; fecal Incontinency; constipation

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DOI: http://dx.doi.org/10.22037/irjps.v3i2.18381


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