Transanal pull-through for Hirschsprung disease in neonates: A single-center experience | [Journal of Neonatal Surgery • 2023]

Author(s):

1. Nahla Kechiche: Pediatric Surgery Department, University Hospital of Monastir, University of Monastir, Tunisia

2. Sahla Sellami: Pediatric Surgery Department, University Hospital of Gabes, University of Sfax, Tunisia

3. Dorsaf Makhlouf: Pediatric Surgery Department, University Hospital of Gabes, University of Sfax, Tunisia

4. Rachida Laamiri: Pediatric Surgery Department, University Hospital of Monastir, University of Monastir, Tunisia

5. Nahla Hmidi: Pediatric Surgery Department, University Hospital of Monastir, University of Monastir, Tunisia

6. Seifeddine Zayani: Pediatric Department, University Hospital of Monastir, University of Monastir, Tunisia

7. Amine Ksia: Pediatric Surgery Department, University Hospital of Monastir, University of Monastir, Tunisia

8. Lassaad Sahnoun: Pediatric Surgery Department, University Hospital of Monastir, University of Monastir, Tunisia

9. Mongi Mekki: Pediatric Surgery Department, University Hospital of Monastir, University of Monastir, Tunisia

10. Mohsen Belghith: Pediatric Surgery Department, University Hospital of Monastir, University of Monastir, Tunisia

Abstract:

Background: Transanal pull-through for the treatment of Hirschsprung disease in the neonatal period remains debatable. This study reported our experience with transanal pull-through in neonates. Methods: We reviewed medical records of neonates with Hirschsprung disease treated in our department with transanal pull-through between the years 2010 and 2016. Results: Of the 40 included patients, 31 were male neonates, and 9 were female. The mean age at the time of surgery was 13 days. The mean operative time was 136 minutes. The level of aganglionosis was rectal in 8 cases, rectosigmoid in 19 cases, descending colon in 7 cases, splenic flexure in 3 cases, transverse colon in 2 cases, and ascending colon in one case. A combined abdominal approach was used in 11 patients. There were no intraoperative complications. Major complications were noted in 4 cases: anastomotic leakage in 3 cases of whom one succumbed 3 days postoperatively; and bowel perforation in one case. The most common late postoperative complication was fecal soiling encountered in 25% of cases. Two among 29 patients who reached the age of continence remain incontinent. Conclusion: Transanal pull-through in neonates has similar outcomes and complications to those of infants and children. Therefore this procedure can be safely employed in neonates however we recommend that the treating team should have an ample learning curve for this procedure in infants

Page(s): 1-29

DOI: 10.47338/jns.v12.1220

Published: Journal: Journal of Neonatal Surgery, Volume: 12, Issue: 1, Year: 2023

Keywords:

newborn , Outcome , Primary transanal pullthrough , Hirschsprung disease

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