Surgical approach and functional outcome of redo pull-through for postoperative complications in Hirschsprung’s disease
| Autor: | Yuchun Yan, Long Li, Zhen Zhang, Ping Xiao, Ya Ma, Qi Li, Yee Low, Qian Jiang |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Laparoscopic surgery medicine.medical_specialty medicine.medical_treatment Fistula Anastomosis Postoperative Complications Laparotomy Pediatric surgery medicine Humans Hirschsprung Disease Hirschsprung's disease Digestive System Surgical Procedures Retrospective Studies Enterocolitis business.industry Anastomosis Surgical Infant Newborn Infant Retrospective cohort study General Medicine medicine.disease Surgery Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Cuff Female business |
| Zdroj: | Pediatric Surgery International. 37:1401-1407 |
| ISSN: | 1437-9813 0179-0358 |
| Popis: | To review our surgical experience and outcome of redo pull-through for various postoperative complications of Hirschsprung’s disease. A retrospective study was performed on children who underwent redo pull-through from 2016 to 2019. Operative methods and functional outcomes were compared between those with anastomotic complications (stricture and fistula, n = 12) and patients without anastomotic complications (n = 24) such as residual aganglionosis/transition zone, twisted pull-through and tight soave cuff. 36 Patients (29 male and 7 female) were included with median age 6 (0.1–54) months at primary and 36 (9–144) months at redo pull-through. A transanal rectal mucosectomy and partial internal anal sphincterectomy (TRM-PIAS) pull-through with laparoscopic (n = 10, 27.8%) or laparotomy (n = 26, 72.2%) assisted techniques were performed for all patients during redo procedure. Patients with anastomotic complications had lower incidence of successful laparoscopic pull-through (0%), higher postoperative complications (25%) after redo surgery, but similar functional outcomes compared to those without anastomotic complications (41.6% underwent laparoscopic surgery, 4.2% complications). Patients with partial colectomy had significantly less soiling (36.4%) and enterocolitis (0%) compared to those with subtotal/total colectomy (79.2% soiling and 58.3% enterocolitis). TRM-PIAS with/without laparoscopic-assisted redo pull-through was effective in treating various complications after primary pull-through. The functional outcome is strongly associated with the length of residual colon after redo pull-though. |
| Databáze: | OpenAIRE |
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