Long-term follow-up of patients treated with ileoendorectal pull-through and right colon onlay patch for total colonic aganglionosis

Abstract Background To present a surgical technique of single-incision laparoscopic-assisted endorectal pull-through (SILEP) with suspension sutures using conventional instruments for Hirschsprung disease (HD) and its long-term follow-up outcomes. Methods The procedure began with a 1 cm transumbilical skin incision. Three separate punctures were made in the fascia with a 5 mm scope in the middle and 5 mm and 3 mm ports for working instruments on the left and right, respectively. The first suspension suture was placed to secure the sigmoid colon to the abdominal wall. A window was created through the rectal mesentery, and dissection around the rectum was carried out. The second suspension suture was performed to suspend the rectovesical peritoneal fold or the rectovaginal peritoneal fold to the abdominal wall. Dissection around the rectum was continued downward to approximately 1 cm below the peritoneal fold. Then, the operation was completed by a transanal approach. Results Forty patients underwent SILEP from March 2013 to April 2015. The median age was 2.7 months (ranging from 1 to 17 months). The mean operative time was 96 ± 23 min. No conversion to an open operation was required. The average hospitalization time was 4.5 ± 2 days. There were no intraoperative or perioperative complications. Long-term follow-up results were obtained from 38 patients. A frequency of defecation from every other day to twice a day was noted for 33 patients (86.8%) and more often for 5 patients (13.2%). Two patients had enterocolitis (5.2%). Conclusion Single-incision laparoscopic rectal pull-through with suspension sutures using conventional instruments is feasible and safe for HD with good long-term outcomes.

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Long-term follow-up of redo pull-through procedures for Hirschsprung's disease: Efficacy of the endorectal pull-through

Journal of Pediatric Surgery ◽

10.1053/jpsu.2000.6853 ◽

2000 ◽

Vol 35 (6) ◽

pp. 829-834 ◽

Cited By ~ 40

Author(s):

Kathleen van Leeuwen ◽

Daniel H. Teitelbaum ◽

Essam A. Elhalaby ◽

Arnold G. Coran

Keyword(s):

Hirschsprung's Disease ◽

Hirschsprung’S Disease ◽

Long Term Follow Up ◽

Pull Through

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Suspension Sutures Facilitate Single Incision Laparoscopic-Assisted Rectal Pull-Through for Hirschsprung Disease

10.21203/rs.3.rs-107785/v1 ◽

2020 ◽

Author(s):

Liem Thanh Nguyen ◽

Anh Nguyen Tho ◽

Quang Nguyen Thanh ◽

Quynh Tran Anh ◽

Hau Bui Duc ◽

...

Keyword(s):

Abdominal Wall ◽

Single Incision ◽

Hirschsprung Disease ◽

Conventional Instruments ◽

Long Term Follow Up ◽

Pull Through ◽

Laparoscopic Assisted ◽

Suspension Suture

Abstract BackgroundTo present the surgical technique and long-term follow-up outcomes of single incision laparoscopic-assisted endorectal pull-through (SILEP) with suspension sutures using conventional instruments for Hirschsprung disease. MethodsThe procedure began with a 1cm transumbilical skin incision. Three separate punctures were made onto the fascia for a 5mm scope in the middle, a 5mm and 3mm ports for working instruments on the left and right, respectively. The first suspension suture was performed to secure the sigmoid colon to the abdominal wall. A window was created through the rectal mesentery, and dissection around the rectum was carried out. The second suspension suture was performed to suspense the rectovesical peritoneal fold or the rectovaginal peritoneal fold to the abdominal wall. Dissection around the rectum was continued downward to approximately 1cm below the peritoneal fold. The operation was completed by a transanal approach. Results40 patients underwent SILEP from March 2013 to April 2015. The median age was 2.7 months (ranged from 14 days to17 months). The mean operative time was 94.7 ± 20 minutes. No conversion to open operation was required. Mean hospital stay was 4.1±1.3 days. There were no intraoperative or perioperative complications. Long term follow-up results were obtained in 38 patients. The number of defecation from 1-2 times per day was noted in 36 patients (94.7%) and from 3-4 times per day in 2 patients (5.2%). Two patients had enterocolitis (5.2%).ConclusionSingle site laparoscopic rectal pull-through with suspension sutures using conventional instruments is feasible and safe for Hirschsprung disease with good long-term outcomes.

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Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

Behavioral and Brain Sciences ◽

10.1017/s0140525x1800105x ◽

2019 ◽

Vol 42 ◽

Cited By ~ 2

Author(s):

John P. A. Ioannidis

Keyword(s):

Mental Health ◽

Mental Disease ◽

Brain Disorders ◽

Social Stressors ◽

Labor Education ◽

Mental Diseases ◽

Long Term Follow Up ◽

Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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X-linked congenital adrenal hypoplasia: new mutations and long-term follow-up in three patients

Clinical Endocrinology ◽

10.1046/j.1365-2265.2000.01038.x ◽

2000 ◽

Vol 53 (2) ◽

pp. 249 ◽

Cited By ~ 17

Author(s):

G. Binder

Keyword(s):

Congenital Adrenal Hypoplasia ◽

Long Term Follow Up ◽

Adrenal Hypoplasia ◽

New Mutations

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