Long-term outcomes in children with Hirschsprung’s disease and transition zone bowel pull-through: impact of surgical techniques and role for conservative approach

Study of 11 children with transition zone bowel in Hirschsprung pull-through demonstrates that conservative management with laxatives and Botox injections successfully resolves symptoms in most cases, with only one requiring revision surgery. Duhamel procedure showed better tolerance of transition zone at anastomotic margin compared to TERP, supporting a conservative-first approach to avoid poorer outcomes from redo interventions.