Comparison of the Results of Transanal Endorectal Pull-through and Martin-modified Duhamel Operations in Hirschsprung Disease
Abstract
Objectives: We compared the results of patients who underwent transanal endorectal pull-through (TEPT) and Martin-modified Duhamel operations for Hirschsprung’s disease (HD).
Materials and Methods: Between 2002 and 2007, we evaluated 53 patients with HD treated with TEPT (group 1, n=24), endorectal pull-through with a laparotomy requirement after an initiated transanal approach (group 2, n=12) and Martin-modified Duhamel (group 3, n=17). Age, gender,length of aganglionic segment, intraoperative details, postoperative early complications and long term functional outcomes are evaluated and compared among these patient groups.
Results: In this study age at the time of the operation, duration of the operation, time to first oral feeding, time to first stool and hospital stay in the patients the group 1 were significantly less or shorter than those ones in group 2 and group 3 (p<0.001). Blood transfusion requirement during operation in group 1 was less than the other groups, but this difference didn’t reach statistical significance (p>0.05). Postoperative enterocolitis had a higher incidence in group 3, but there was also no significant difference (p>0.05). There was no difference in the long-term functional results(continence, fecal soiling, constipation) of all three procedures (p>0.05).
Conclusion: TEPT is both a feasible and safe technique. It may be the first choice particularly in patients with early diagnosed rectosigmoid HD patients without enterocolitis or bowel dilatation.
Keywords
Words: Transanal Endorectal Pull-through, Hirshsprung’s Disease, Duhamel Pull-through
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