Laparoscopic-assisted transanal pull-through for hirschsprung's children older than 3 years: A case series
Context: Hirschsprung's disease (HD) is a congenital anomaly affecting the enteric nervous system commonly the rectosigmoid region. Treatment is surgical where the aganglionic segment is resected, and bowel continuity is restored by a coloanal anastomosis. In 1999, Georgeson et al. proposed a n...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2021-01-01
|
| Series: | African Journal of Paediatric Surgery |
| Subjects: | |
| Online Access: | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2021;volume=18;issue=4;spage=210;epage=214;aulast=Arafa |
| _version_ | 1819081195610177536 |
|---|---|
| author | Ahmed Arafa Wesam Mohamed Heba Taher Moutaz Ragab Mohamed Hamed Abouelfadl |
| author_facet | Ahmed Arafa Wesam Mohamed Heba Taher Moutaz Ragab Mohamed Hamed Abouelfadl |
| author_sort | Ahmed Arafa |
| collection | DOAJ |
| description | Context: Hirschsprung's disease (HD) is a congenital anomaly affecting the enteric nervous system commonly the rectosigmoid region. Treatment is surgical where the aganglionic segment is resected, and bowel continuity is restored by a coloanal anastomosis. In 1999, Georgeson et al. proposed a new technique of primary laparoscopic-assisted pull-through for HD as a new gold standard. Aim: The aim of the study was to evaluate the outcome of the laparoscopic-aided transanal pull-through procedure for the management of HD in children older than 3 years of age. Methods: This study was conducted on 15 consecutive patients presented to a university hospital, diagnosed as having HD relying on their clinical features, barium enema study and rectal biopsy. In all cases, laparoscopic-assisted transanal pull-through was attempted. The laparoscopic part included transition zone identification, seromuscular biopsy for fresh frozen histopathology and sigmoid and rectal mobilisation as much as possible down the peritoneal reflection. The transanal part included mobilisation of the rectal lower segment by 2–3 cm, resection till the ganglionic segment, and full-thickness two-layer coloanal anastomosis was done. Results: Early complications occurred in eight cases: enterocolitis in four cases and perianal excoriation occurred in four cases. There were no cases of anastomotic leak. Late complications occurred in seven patients: four cases developed stricture at the site of coloanal anastomosis and three cases experienced enterocolitis at 6 and 9 months postoperatively. Conclusion: Laparoscopic-aided transanal pull-through procedure is a safe, feasible modality for the management of HD in children more than 3 years. |
| first_indexed | 2024-12-21T19:56:55Z |
| format | Article |
| id | doaj.art-bf6d6c7fe5f942a3bfa6721bd24fc876 |
| institution | Directory Open Access Journal |
| issn | 0189-6725 |
| language | English |
| last_indexed | 2024-12-21T19:56:55Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | African Journal of Paediatric Surgery |
| spelling | doaj.art-bf6d6c7fe5f942a3bfa6721bd24fc8762022-12-21T18:52:04ZengWolters Kluwer Medknow PublicationsAfrican Journal of Paediatric Surgery0189-67252021-01-0118421021410.4103/ajps.AJPS_161_20Laparoscopic-assisted transanal pull-through for hirschsprung's children older than 3 years: A case seriesAhmed ArafaWesam MohamedHeba TaherMoutaz RagabMohamed Hamed AbouelfadlContext: Hirschsprung's disease (HD) is a congenital anomaly affecting the enteric nervous system commonly the rectosigmoid region. Treatment is surgical where the aganglionic segment is resected, and bowel continuity is restored by a coloanal anastomosis. In 1999, Georgeson et al. proposed a new technique of primary laparoscopic-assisted pull-through for HD as a new gold standard. Aim: The aim of the study was to evaluate the outcome of the laparoscopic-aided transanal pull-through procedure for the management of HD in children older than 3 years of age. Methods: This study was conducted on 15 consecutive patients presented to a university hospital, diagnosed as having HD relying on their clinical features, barium enema study and rectal biopsy. In all cases, laparoscopic-assisted transanal pull-through was attempted. The laparoscopic part included transition zone identification, seromuscular biopsy for fresh frozen histopathology and sigmoid and rectal mobilisation as much as possible down the peritoneal reflection. The transanal part included mobilisation of the rectal lower segment by 2–3 cm, resection till the ganglionic segment, and full-thickness two-layer coloanal anastomosis was done. Results: Early complications occurred in eight cases: enterocolitis in four cases and perianal excoriation occurred in four cases. There were no cases of anastomotic leak. Late complications occurred in seven patients: four cases developed stricture at the site of coloanal anastomosis and three cases experienced enterocolitis at 6 and 9 months postoperatively. Conclusion: Laparoscopic-aided transanal pull-through procedure is a safe, feasible modality for the management of HD in children more than 3 years.http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2021;volume=18;issue=4;spage=210;epage=214;aulast=Arafahirschsprung's diseaselaparoscopic assistedminimally invasive surgery |
| spellingShingle | Ahmed Arafa Wesam Mohamed Heba Taher Moutaz Ragab Mohamed Hamed Abouelfadl Laparoscopic-assisted transanal pull-through for hirschsprung's children older than 3 years: A case series African Journal of Paediatric Surgery hirschsprung's disease laparoscopic assisted minimally invasive surgery |
| title | Laparoscopic-assisted transanal pull-through for hirschsprung's children older than 3 years: A case series |
| title_full | Laparoscopic-assisted transanal pull-through for hirschsprung's children older than 3 years: A case series |
| title_fullStr | Laparoscopic-assisted transanal pull-through for hirschsprung's children older than 3 years: A case series |
| title_full_unstemmed | Laparoscopic-assisted transanal pull-through for hirschsprung's children older than 3 years: A case series |
| title_short | Laparoscopic-assisted transanal pull-through for hirschsprung's children older than 3 years: A case series |
| title_sort | laparoscopic assisted transanal pull through for hirschsprung s children older than 3 years a case series |
| topic | hirschsprung's disease laparoscopic assisted minimally invasive surgery |
| url | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2021;volume=18;issue=4;spage=210;epage=214;aulast=Arafa |
| work_keys_str_mv | AT ahmedarafa laparoscopicassistedtransanalpullthroughforhirschsprungschildrenolderthan3yearsacaseseries AT wesammohamed laparoscopicassistedtransanalpullthroughforhirschsprungschildrenolderthan3yearsacaseseries AT hebataher laparoscopicassistedtransanalpullthroughforhirschsprungschildrenolderthan3yearsacaseseries AT moutazragab laparoscopicassistedtransanalpullthroughforhirschsprungschildrenolderthan3yearsacaseseries AT mohamedhamedabouelfadl laparoscopicassistedtransanalpullthroughforhirschsprungschildrenolderthan3yearsacaseseries |