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---

Abstract


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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.

Results:

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.


Keywords


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

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References


Stensrud KJ, Emblem R, Bjørnland K. Functional outcome after operation for Hirschsprung disease—transanal vs transabdominal approach. Journal of pediatric surgery. 2010;45(8):1640-4.

Zakaria OM, El Labban GM, Shams ME. Fecal incontinence after single-stage Soave’s pull-through: abdominal versus transanal endorectal pull-through. Annals of Pediatric Surgery. 2012;8(1):5-8.

Coran AG, Caldamone A, Adzick NS, Krummel TM, Laberge J-M, Shamberger R. Pediatric surgery: Elsevier Health Sciences; 2012.

Puri P. Variant Hirschsprung's disease. Journal of pediatric surgery. 1997;32(2):149-57.

Lewis NA, Levitt MA, Zallen GS, Zafar MS, Iacono KL, Rossman JE, et al. Diagnosing Hirschsprung's disease: increasing the odds of a positive rectal biopsy result. Journal of pediatric surgery. 2003;38(3):412-6.

Mattar AF, Coran AG, Teitelbaum DH. MUC-2 mucin production in Hirschsprung's disease: possible association with enterocolitis development. Journal of pediatric surgery. 2003;38(3):417-21.

Zakaria OM. Bowel function and fecal continence after Soave’s trans-anal endorectal pull-through for Hirschsprung’s disease: a local experience. Updates in surgery. 2012;64(2):113-8.

De la Torre-Mondragon L, Ortega-Salgado J. Transanal endorectal pull-through for Hirschsprung's disease. Journal of pediatric surgery. 1998;33(8):1283-6.

Catto-Smith AG, Coffey CM, Nolan TM, Hutson JM. Fecal incontinence after the surgical treatment of Hirschsprung disease. The Journal of pediatrics. 1995;127(6):954-7.

Wang N-L, Lee H-C, Yeh M-L, Chang P-Y, Sheu J-C. Experience with primary laparoscopy-assisted endorectal pull-through for Hirschsprung’s disease. Pediatric surgery international. 2004;20(2):118-22.

Yanchar NL, Soucy P. Long-term outcome after Hirschsprung's disease: patients' perspectives. Journal of pediatric surgery. 1999;34(7):1152-60.

De la Torre L, Ortega A. Transanal versus open endorectal pull-through for Hirschsprung's disease. Journal of pediatric surgery. 2000;35(11):1630-2.

Langer JC, Durrant AC, de la Torre L, Teitelbaum DH, Minkes RK, Caty MG, et al. One-stage transanal Soave pullthrough for Hirschsprung disease: a multicenter experience with 141 children. Annals of surgery. 2003;238(4):569-76.

Elhalaby EA, Hashish A, Elbarbary M, Soliman H, Wishahy M, Elkholy A, et al. Transanal one-stage endorectal pull-through for Hirschsprung’s disease: a multicenter study. Journal of pediatric surgery. 2004;39(3):345-51.




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

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