Vojnosanitetski pregled 2016 Volume 73, Issue 3, Pages: 246-250
https://doi.org/10.2298/VSP140516002L
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Effectiveness of various surgical methods in treatment of Hirschsprung’s disease in children
Lukač Marija (University Children’s Hospital, Department of Pediatric Surgery, Belgrade + Faculty of Medicine, Belgrade)
Sinđić-Antunović Sanja (University Children’s Hospital, Department of Pediatric Surgery, Belgrade + Faculty of Medicine, Belgrade)
Vujović Dragana (University Children’s Hospital, Department of Pediatric Surgery, Belgrade)
Petronić Ivana (Faculty of Medicine, Belgrade + University Children’s Hospital, Department of Physical Medicine and Rehabilitation, Belgrade)
Nikolić Dejan (University Children’s Hospital, Department of Physical Medicine and Rehabilitation, Belgrade)
Radlović Vladimir (University Children’s Hospital, Department of Pediatric Surgery, Belgrade)
Krstajić Tamara (University Children’s Hospital, Department of Neonatology, University Children’s Hospital, Belgrade,)
Krstić Zoran (University Children’s Hospital, Department of Pediatric Surgery, Belgrade + Faculty of Medicine, Belgrade)
Background/Aim. Hirschsprung’s disease is the most common identifiable
developmental disorder of the enteric nervous system, characterized by a
failure of its formation in a variable segment of distal bowel. Currently
available surgical therapies for Hirschsprung’s disease, although lifesaving,
are associated with numerous complications. The aim of our study was to
evaluate the effectiveness of different surgical methods and the incidence of
serious complications after radical surgery of rectosigmoid Hirschsprung’s
disease. Methods. A retrospective analysis, from June 1997 until May 2012 was
carried out on 84 patients operated for Hirschsprung’s disease of
rectosigmoid colon. Transanal endorectal pull-through was performed in 30
(35.7%) patients (group I), while 54 (64.3%) patients were operated by other
(Soave, Duhamel or Swenson) procedures (group II). The age at operation, the
incidence and severity of postoperative complications, the need for previous
colostomy and the number of reoperations are countered in order to evaluate
the efficacy of surgical procedures. Results. In the group I, the mean age at
operation was 9.41 ± 6.37 months and in the group II the mean age at
operation was 16.8 ± 13.9 months which was significantly higher (p < 0.01).
In the group I there were only 3 (10%) patients with complications, one (3%)
of them was prone to only one redo procedure (1.00 ± 0.00) and there was no
need for previous colostomy in all patients (100%). In the group II there
were 16 (30%) patients with significantly frequent complications (p < 0.05),
about 2 reoperations on the average (1.94 ± 1.84) in 4 of them (25%) and 22
(41%) redo procedures, which was, in total, significantly higher than in the
group I (p < 0.01). Only Soave’s procedure was performed without previous
colostomy in 20 (37%) patients. Conclusion. Transanal endorectal pull-through
in surgical treatment of patients with Hirschsprung’s disease is more
effective than other procedures concerning earlier onset, low incidence and
less severe complications, which would require further operations, and no
scars.
Keywords: hirschsprung disease, surgical procedures, operative, postoperative complications, reoperation, child