One Stage Transanal Swenson-Like Pull-Through Operation: Our Early Experience

Authors

  • Nita Mariana Paediatric Surgery Division, Department of Surgery, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi
  • Farid Nur Mantu Paediatric Surgery Division, Department of Surgery, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi
  • Andi Asadul Islam Neurosurgery Division, Department of Surgery, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi
  • Warsinggih Warsinggih Paediatric Surgery Division, Department of Surgery, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi
  • Nasrum Massi Neurosurgery Division, Department of Surgery, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi
  • Mochammad Hatta Neurosurgery Division, Department of Surgery, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi
  • Harris Bartimeus Paediatric Surgery Division, Department of Surgery, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi

Keywords:

Hirschsprung Disease, Rectosigmoid, Transanal.

Abstract

Operative management of Hisrchsprung Disease (HD) has evolved from staged operation to one stage minimal invasive operation.  One stage transanal Swenson-like pullthrough operation is the latest concept of one stage procedure in managing HD.  We evaluate early outcome of one stage transanal Swenson-like pullthrough operation for managing PH located at rectosigmoid in our institution during 2017.  Our follow up evaluate the incidence of post operative stricture or stenosis, anastomotic leakage, enterocolitis, urinary dan defecating function.  Six patients underwent transanal resection with age ranging from 11 months to 5 years.  Average length of resected intestinal is 10 ± 5 cm.  Mostly, patient came back to office after 3 months.  No post operative incidence of urethral injury, anastomotic leakage or retraction at anastomotic site were reported.  There were  reports of 1 patient with intraoperative bleeding, 1 patient anal excoriation due to enterocolitis and 1 patient with stenosis.  There were no patient reported with urinating and defecating disorders.  There were no mortality incidence in this study. Despite the need of long term observation for evaluating urinating and defecating function, modification of transanal Swenson-like method might be used in managing HD.

References

. Green, Holly L. MPAS, PA-C; Rizzolo, Denise PhD, PA-C; Austin, Mary MD, MPH. Surgical management for Hirschsprung disease: A review for primary care providers. Journal of the American Academy of Physician Assistants: April 2016 - Volume 29 - Issue 4 - p 24–2doi: 10.1097/01.JAA.0000481397.68475.41

. A. K. M. Zahid Hossain, Gazi Zahirul Hasan, Susankar Kumar Mandal, Md. Nooruzzaman, A. Shahinoor and Dinesh Prasad Koirala.One stage transanal full thickness pull-through operation for rectosigmoid Hirschsprung's disease. Bangabandhu Sheikh Mujib Medical University Journal, Vol 9, No 3 (2016)

. Schäppi MG, Staiano A, Milla PJ, et al. A practical guide for the diagnosis of primary enteric nervous system disorders. J Pediatr Gastroenterol Nutr. 2013;57(5):677–686.

. Langer JC, Seifert M, Minkes RK. One stage Soave pull-through for Hirschsprung’s disease: A comparison of the trans anal VS open approaches. J Pediatr Surg. 2000: 35: 820-22.

. De La Torre L, Langer JC. Transanal endorectal pull-through for Hirschsprung disease: technique, controversies, pearls, pitfalls, and an organized approach to the management of postoperative obstructive symptoms. Semin Pediatr Surg. 2010;19(2):96–106.

. Xu ZL, Zhao Z, Wang L. A new modification of transanal Swenson pull-through procedure for Hirschsprung's disease. Chin Med J 2008;121:2420–3.

. Kessmann J. Hirschsprung's disease: diagnosis and management. Am Fam Physician. 2006;74(8):1319–1322.

. Vult von Steyern K, Wingren P, Wiklund M, et al. Visualisation of the rectoanal inhibitory reflex with a modified contrast enema in children with suspected Hirschsprung disease. Pediatr Radiol. 2013;43(8):950–957.

. Friedmacher F, Puri P. Rectal suction biopsy for the diagnosis of Hirschsprung's disease: a systematic review of diagnostic accuracy and complications. Pediatr Surg Int. 2015;31(9):821–830.

. Hayes CE, Kawatu D, Mangray S, LeLeiko NS. Rectal suction biopsy to exclude the diagnosis of Hirschsprung disease. J Pediatr Gastroenterol Nutr. 2012;55(3):268–271.

. Langer JC, Durrant AC, de la Torre L, et al. One-stage transanal Soave pullthrough for Hirschsprung disease: a multicenter experience with 141 children. Ann Surg. 2003;238(4):569–583.

. Weidner BC, Wald hausen JH. Swenson revisited: A one-stage transanal pull-through procedure for Hirschsprung’s disease. J Pediatric Surg. 2003: 38:1208-11.

. Mahajan JK. Rathod KK. Bawa M, Narasinham KL. Transanal Swenson’s operation for recto-sigmoid Hirschsprung’s disease. Afr J Peditr Surg. 2011; 8: 301-05.

. 24. Temple SJ, Shawyer A, Langer JC. Is daily dilatation by parents necessary after surgery for Hirschsprung disease and anorectal malformations. J Pediatr Surg. 2012;47(1):209–212.

. Nasr A, Langer JC. Evolution of the technique in the transanal pull-through for Hirschsprung's disease: effect on outcome. J Pediatr Surg. 2007;42(1):36–40.

. Levitt MA, Dickie B, Pena A. Evaluation and treatment of the patient with Hirchsprung’s disease who is not doing well after pull-through procedure. Semin Paediatr Surg. 2010; 19: 146-53.

Downloads

Published

2019-07-27

How to Cite

Mariana, N., Nur Mantu, F., Asadul Islam, A., Warsinggih, W., Massi, N., Hatta, M., & Bartimeus, H. (2019). One Stage Transanal Swenson-Like Pull-Through Operation: Our Early Experience. International Journal of Sciences: Basic and Applied Research (IJSBAR), 48(1), 25–29. Retrieved from https://www.gssrr.org/index.php/JournalOfBasicAndApplied/article/view/10205

Issue

Section

Articles