Transanal endorectal vs. Duhamel pull-through for Hirschsprung's disease

Eur J Pediatr Surg. 2010 Jul;20(4):242-6. doi: 10.1055/s-0030-1252006. Epub 2010 Apr 14.

Abstract

Introduction: The aim of this study was to test the hypothesis that the early functional outcome for patients with rectosigmoid Hirschsprung's disease (HD) is comparable for the Duhamel pull-through procedure and the transanal endorectal pull-through (TERPT) procedure, with less discomfort for the patient postoperatively after the TERPT technique.

Material and methods: Eleven patients operated on with the TERPT technique (T Group) were prospectively registered and compared retrospectively with 18 patients operated on with the Duhamel pull-through (D Group). Data recorded included patient demographics, operative treatment, complications, hospital stay and bowel functions. The follow-up time was limited to 24 months.

Results: The T Group started oral feeding sooner, their bowel movements started sooner and they had less need for analgesia postoperatively and a significantly shorter hospital stay. 71% of the patients in the D Group needed re-intervention compared to only 18% of the T Group. Enterocolitis was seen in two patients in both groups. At the last clinical control ten patients had constipation (59%) and three had soiling (18%) in the D Group. Three patients in the T Group had constipation (27%) and one had soiling (9%).

Conclusion: Our results support the use of the TERPT method rather than the Duhamel pull-through for rectosigmoid HD.

Publication types

  • Comparative Study

MeSH terms

  • Anal Canal / surgery*
  • Child, Preschool
  • Defecation
  • Digestive System Surgical Procedures / methods*
  • Endoscopy, Digestive System / methods*
  • Female
  • Follow-Up Studies
  • Hirschsprung Disease / diagnosis
  • Hirschsprung Disease / physiopathology
  • Hirschsprung Disease / surgery*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Rectum / surgery*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome