One-stage transanal endorectal pull-through for Hirschsprung disease: experience with 229 neonates
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In brief
In brief
Large retrospective study of 229 neonates demonstrates that one-stage transanal endorectal pull-through is safe and effective for Hirschsprung disease in the first month of life. With 14-year follow-up, the procedure shows low complication rates and 80% of patients achieve good bowel function scores by age four.
Written by the GCMD Library team from the article.
Abstract
Objective
To evaluate the safety and efficacy of transanal endorectal pull-through (TEPT) and the long-term outcomes in newborns with Hirschsprung disease (HD).
Methods
A total of 229 newborns with HD underwent one-stage TEPT between 2007 and 2020, and the diagnoses were confirmed by rectal biopsy. The perioperative clinical course for all patients was reviewed, and the postoperative short- and long-term outcomes were assessed.
Results
A total of 229 neonates (187 male and 42 female) had a median age at TEPT of 17 days (range 6–28 days). Sixty-eight patients (29.7%) underwent TEPT combined with an abdominal approach or laparoscopy. Early postoperative complications (using the Clavien–Dindo grading system) were documented in 36 patients (15.7%), and late postoperative complications were noted in 9 patients (3.9%). The follow-up period in the remaining 165 children ranged from 1.2 to 14.0 years (median 5.0 years). A total of 106 of the patients older than four years old took part in an interview about bowel function, and 85 patients (80.2%) had bowel function scores (BFS) ≥ 18.
Conclusion
TEPT is effective and safe for HD in the neonatal period and presents with a low rate of complications and an acceptable outcome.