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Skarsgard ED, Superina RA, Shandling B, et al. Initial experience with one-stage endorectal pull-through procedures for Hirschsprung's disease. Pediatr Surg Int. 2013;11(7):480-2doi: 10.1007/BF00180088.
Skarsgard, E. D., Superina, R. A., Shandling, B., & Wesson, D. E. (1996). Initial experience with one-stage endorectal pull-through procedures for Hirschsprung's disease. Pediatric surgery international, 11(7), 480-2. https://doi.org/10.1007/BF00180088
Skarsgard, E D, et al. "Initial experience with one-stage endorectal pull-through procedures for Hirschsprung's disease." Pediatric surgery international vol. 11,7 (1996): 480-2. doi: https://doi.org/10.1007/BF00180088
Skarsgard ED, Superina RA, Shandling B, Wesson DE. Initial experience with one-stage endorectal pull-through procedures for Hirschsprung's disease. Pediatr Surg Int. 1996 Aug;11(7):480-2. doi: 10.1007/BF00180088. Epub 2013 Sep 21. PMID: 24057788.
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Pediatr Surg Int. 1996 Aug;11(7):480-2. doi: 10.1007/BF00180088. Epub 2013 Sep 21.

Initial experience with one-stage endorectal pull-through procedures for Hirschsprung's disease.

Pediatric surgery international

E D Skarsgard, R A Superina, B Shandling, D E Wesson

Affiliations

  1. Department of Surgery, Hospital for Sick Children, M5G 1X8, Toronto, Ontario, Canada.

PMID: 24057788 DOI: 10.1007/BF00180088

Abstract

To evaluate our experience with one-stage endorectal pull-through (ERPT) procedures (without colostomy) for Hirschsprung's disease (HD), we compared 7 such patients to a cohrt of 20 consecutive patients undergoing EROT folowing colostomy. Reasons for exclusion from hte cohort group included: (1) bowel obstruction requiring operation before 1 month of age; (2) presentation with enterocolitis (EC), intestinal perforation, or massive fecal distension; (3) long-segment disease; or (4) severe associated anomalies. The 7 male patients in the single-stage ERPT group first presented at a median age of 16 days (4 days-2.5 years) and were managed by regular digital dilation or colonic irrigation for between 1 and 6 months (median 2 months) prior to surgery. Single-stage procedures were performed at a median age and weight of 4 months (2 months-2.5 years) and 6.4 kg (4.5-13.8 kg), respectively Median hospitalization for these patients was 9 dyas. Postoperative complications occurred in 2 patients (29%), and included anastomotic stricture requiring outpatient dilation, and 1 case or recurrent EC that responded to a course of anal dilations. The cohort group (14 M, 6 F) presented at a median of 15 months. All underwent colostomy as a primary procedure. ERPT was deferred until a median age of 21 months, and the hospitalization after pull-through averaged 10 dyas (20 days including stay after colostomy). Four patient (20%) developed complications requiring reoperation following the initial colostomy. Complications after ERPT occurred in 5 patients (25%) and included 1 death from fulminant Hirschsprung's EC. Other complications included 1 anastomotic stricture and 2 mucosal prolapses requiring anoplasty. Long-term functional results were similar in both groups. Despit our limited experience, we conclude that one-stage ERPT can be safely performed in infants, including those under 3 months of age, with rectosigmoid HD. Total duration of hospitalization is reduced and colostomy complications are avoided. Functional outcome appears to be comparable between patients treated in one or two stages.

References

  1. Surgery. 1948 Aug;24(2):212-20 - PubMed
  2. J Pediatr Surg. 1972 Oct-Nov;7(5):546-52 - PubMed
  3. J Pediatr Surg. 1989 Oct;24(10):1032-4 - PubMed
  4. Surgery. 1994 May;115(5):551-6 - PubMed
  5. Arch Dis Child. 1964 Apr;39:116-24 - PubMed
  6. J Pediatr Surg. 1980 Aug;15(4):470-1 - PubMed
  7. Surgery. 1964 Nov;56:1015-7 - PubMed
  8. Dis Colon Rectum. 1964 Nov-Dec;7:455-8 - PubMed

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