Jiménez-Urueta PS, Castañeda-Ortiz RA, Sánchez-Michaca VJ

Language: Spanish
References: 15
Page: 51-56
PDF size: 169.21 Kb.

ABSTRACT

Introduction: In 1948, the discovery of the cause of this disease was based on a series of clinical observations indicating that there was a defective segment of distal colon producing a partial bowel obstruction. The original operation (the Swenson procedure) consisted of freeing the defective distal colon from within the pelvis by careful sharp extrarectal dissection down to 2 cm above the anal canal and performing an end-to-end anastomosis. During the past decade, there has been a trend to operate on infants in the first weeks of life without a preliminary colostomy.
Material and methods: Our study patients pediatrics with transanal and open endorectal pull-through for Hirschsprung’s disease without a preliminary colostomy January 2000 at June 2006. Rectal biopsy establish the diagnosis. One caution in performing rectal biopsy for the diagnosis of Hirschsprung’s disease is the recognition that there is normally a 2-cm band in the distal rectum at the level of the internal anal sphincter devoid of ganglion.
Results: Tirtheen patients were treated with excision of the entire aganglionic colon with anastomosis of the terminal colo-anal. Six female, seven male. Eleven without a preliminary colostomy. These patients difficult postoperative period with frequent stools. One of the most serious complications of a Hirschsprung’s disease pull-through is a leak at the anastomosis. One patient have leak anastomosis.
Discussion: The last years have seen the successful application of operative therapy to the management of Hirschsprung’s disease, but controversy continues over the issue of what is the best operation.

REFERENCES

1. O’Neill JA. Pediatric Surgery. Mosby. St. Louis, Missouri 1998, Vol. II: 1381-1424.

2. Martuccielo G, Ceccherini I. Pathogenesis of Hirschsprung’s Disease. J Pediatr Surg 2000; 35: 1017-1025.

3. Sullivan P. Hirschsprung. Arch Disease Child 1996; 74: 5-7.

4. Scott N, Nance M. Pediatric Surgery First of Two Parts. N Engl J Med 2000; 342; 22: 1651-1657.

5. Patwardhan N. Colostomy for Anorectal Anomalies: High Incidence of Complications. J Pediatr Surg 2002; 36: 795-798.

6. Teeraratkul S. Transanal One-Stage Endorectal Pull-Through for Hirschsprung’s Disease in Infants and Children. J Pediatr Surg 2003; 38: 184-187.

7. De la Torre L, Ortega A. Transanal versus Open Endorectal Pull-Through for Hirschsprung’s Disease. J Pediatr Surg 2000; 35: 1630-1632.

8. Gao Y, Li G, Zhang X. Primary Transanal Rectosigmoidectomy for Hirschsprung’s Disease: Preliminary Results in the Initial 33 Cases. J Pediatr Surg. 2001; 36: 1816-1819.

9. Shankar KR, Losty GL. Transanal Endorectal Coloanal Surgery for Hirschsprung’s Disease: Experience in Two Centers. J Pediatr Surg 2000; 35: 1209-1213.

10. Hadidi A. Trasanal Endorectal Pull-Through for Hirschsprung’s Disease: A Comparison with the Open Technique. Eur J Pediatr Surg 2003; 13: 176-180.

11. Keith G, Roger C. Primary Laparoscopic-Assisted Endorectal Colon Pull-Through for Hirschsprung’s Disease: A New Gold Standard. An Surg 1999; 229: 678-676.

12. Ghose SI, Squire BR. Hirschsprung’s Disease: Problems with Transition-Zone Pull-Through. J Pediatr Surg 2000; 35: 1085-1809.

13. Fabio L. Modified Transanal Rectosigmoidectomy for Hirschsprung’s Disease Clinical and Manometric Results in the Initial 20 Cases. 2003; 38: 1048-1050.

14. Minford A, Turnock R. Comparison of Functional Outcomes of Duhamel and Transanal Endorectal Coloanal Anastomosis for Hirschsprung’s Disease. J Pediatr Surg 2004; 39: 161-165.

15. Langer J, Durrant A. One-Stage Transanal Soave Pull-Through for Hirschsprung’s Disease: A Multicenter Experience with 141 Children. An Surg 2003; 238: 569-576.