Transanal Endorectal Pull-Through for Hirschsprung's Disease: Complications and Lessons from Our Practice and the Literature.

Gołębiewski, Andrzej; Anzelewicz, Stefan; Sosińska, Daria; Osajca-Kanyion, Monika

Background/Objectives: Hirschsprung's disease (HD) is a congenital disorder characterised by the absence of ganglion cells in the distal bowel, resulting in functional obstruction. The transanal endorectal pull-through (TEPT) procedure, a minimally invasive approach, aims to treat HD by removing the aganglionic segment. This study assessed the feasibility, safety, and efficacy of single-stage TEPT in paediatric patients, focusing on postoperative complications, bowel function, and quality of life. Methods: A retrospective cohort study was conducted on 150 children who underwent single-stage TEPT from January 2005 to December 2023 at the Medical University of Gdansk. Data were collected from medical records, including demographics, preoperative assessments, surgical details, postoperative management, and follow-up outcomes. Statistical analyses were performed using Microsoft Excel 365 and the programming language Python 3.12. The mean age at surgery was 13 months, with a male-to-female ratio of 2.75:1. The mean operative time was 129 min, and the mean hospital stay was seven days. Results: Postoperative complications included anastomotic leak (4%), wound infections (15%), and enterocolitis (26%). Redo surgeries were required in 18% of cases due to persistent constipation and obstructive symptoms. This article includes a comprehensive review of the literature. Conclusions: TEPT demonstrates a favourable safety profile and efficacy in treating HD, though significant concerns include complications such as enterocolitis and the need for additional surgeries. Surgical expertise and thorough preoperative and postoperative management are crucial to optimising patient outcomes.

POLAND; POSTOPERATIVE care; PATIENT safety; ACADEMIC medical centers; DOWN syndrome; MANOMETERS; T-test (Statistics); FECAL incontinence; SURGICAL anastomosis; SEX distribution; MINIMALLY invasive procedures; TREATMENT effectiveness; RETROSPECTIVE studies; DESCRIPTIVE statistics; ENTEROCOLITIS; DIGESTIVE organ surgery; SURGICAL complications; PEDIATRICS; LONGITUDINAL method; HYPOSPADIAS; COLOSTOMY; HIRSCHSPRUNG'S disease; QUALITY of life; MEDICAL records; ACQUISITION of data; FAILURE to thrive syndrome; DEFECATION; DATA analysis software; SURGICAL site infections; CRYPTORCHISM; ANTIBIOTIC prophylaxis; CONSTIPATION; GASTROESOPHAGEAL reflux; EVALUATION

Children, 2024, Vol 11, Issue 9, p1059

2227-9067

Academic Journal

10.3390/children11091059