Laparoscopic assisted versus complete transanal pullthrough in management of Hirschsprung’s Disease: A short term comparative study

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Amira Ebrahim ◽  
Tarek Gobran ◽  
Amin Saleh ◽  
Wael Elshahat ◽  
Omar elekiabi
Keyword(s):  
Comparative Study ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Short Term ◽  
Laparoscopic Assisted

Outcome of Short-Term and Long Term Antibiotic Prophylaxis in Colostomy Closure

2016 ◽  
Vol 4 (2) ◽  
pp. 43-48
Author(s):  
Md Jamal Saleh Uddin ◽  
Sukumar Chakrabarti ◽  
Md Shahidul Islam
Keyword(s):  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Anorectal Malformation ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Colostomy Closure ◽  
Term Therapy ◽  
Short Term ◽  
Sigmoid Colostomy

Background and Objectives: Antibiotic prophylaxis is a common practice in children undergoing colostomy closure for anorectal malformation, Hirschsprung's disease. Traditionally, antibiotics are given for unnecessarily longer period of time, which consumes scarce health resources having alternate efficient use. The present study was undertaken to compare the outcome between short-term and long-term antibiotic prophylaxis in colostomy closure. Materials & Methods: This randomized clinical trial was conducted in Dhaka Shishu Hospital, Dhaka over a period of 15 months from April 2001 to June 2002. Children admitted with anorectal malformation, Hirschsprung's disease for colostomy closures were the study population. However, immuno-compromised children or children already getting antibiotics were excluded from the study. A total of 46 such children were consecutively included and were randomly allocated to long-term group (n = 21) and short-term group (n = 25). The long-term group received antibiotic up to 5th postoperative day, while the short-term group received the same antibiotic up to 2nd postoperative day. Transverse colostomy was the main procedure employed in colostomy closure; however, a few patients required sigmoid colostomy. The outcome measures were incidence of wound infection, hospital stay and cost of treatment. Result: Majority of the children were between 1 - 5 years of age (75% in short-term and 50% in long-term group) followed by under 1 year (10% in short-term and 40% in long-term group) and > 5 years (15% in short-term and 10% in long-term group). The overall male to female ratio was 3:1. Majority (85%) of the patients in both long­term and short-term groups belonged to lower income group. Over half (52.2%) of the children had anorectal malformations (ARM) and the rest (47.8%) had Hirschsprung's disease (HD). Children were generally malnourished according to Gomez classification. Majority (91%) was operated on by transverse colostomy and few (9%) by sigmoid colostomy. Three patients in each group developed postoperative wound infection. Blood culture of none of these patients yielded growth of any organism, though wound swab culture did so in 5 cases out of 6 infected patients. In 2 cases, the organism was E.coli, in 2 cases, it was Pseudomonas and in one case Staph. aureus. Total cost of antibiotics in short-term therapy was less than 50% of that required in long-term therapy. The outcome in terms of recovery, complications and postoperative hospital stay was no different between groups. Conclusion: The study concluded that short-term antibiotic prophylaxis is as efficacious as long-term in preventing wound infection in patients with colostomy closure for anorectal malformation and Hirschsprung's disease. Short-term antibiotic prophylaxis is cost-effective Ibrahim Cardiac Med J 2014; 4(2): 43-48

scholarly journals A comparative study between the single-stage transanal and Soave-Boley pull-through for short segment Hirschsprung's Disease

1970 ◽  
Vol 22 (1) ◽  
pp. 20-24
Author(s):  
Md Momtazul Hoque ◽  
Md Akbar Husain Bhuiyan ◽  
Md Nur Hossain Bhuiyan ◽  
Shah Alam Talukder ◽  
Tahmina Banu
Keyword(s):  
Comparative Study ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Single Stage ◽  
Short Segment ◽  
Pull Through

Keywords: Soave-Boley Pull; entercolitis; hirschsprung's diseaseDOI: http://dx.doi.org/10.3329/jcmcta.v22i1.9107 JCMCTA 2011; 22(1): 20-24

scholarly journals Early and long-term complications following transanal pull through Soave technique in infants with Hirschsprung's diseaseric infants with Hirschsprung's disease

2019 ◽  
Author(s):  
Manoochehr Ghorbanpour ◽  
Mohammad Ali Seyfrabie ◽  
Babak Yousefi
Keyword(s):  
Intestinal Obstruction ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Statistical Tests ◽  
Case Series ◽  
P Value ◽  
Short Term ◽  
Case Series Study ◽  
The Mean

Objective. Patients undergoing Soave surgery for Hirschsprung's disease are at risk for some complications. The aim of this study was to investigate such short-term and long-term complications and evaluate the outcome of the operation in these patients. Methods. A case series study was carried out during the last 12 years, during 2007 to 2018 in Besat hospital of Hamadan. Data collection conducted using a checklist includes questions about demographic information, clinical features, and short-term and long-term complications, and consequences of post-operative surgery. The findings of the study were analyzed using SPSS software version 20 and appropriate statistical tests. P-value less than 0.05 was considered statistically significant. Results. A total of 55 children underwent Soave surgery during the last 12 years in Besat Hospital Hamadan, Iran. The mean age of the patients was 38±10 days during surgery, of which 56.4% were female. The mean hospital stay was 7.3 days. Also, the mean weight of children at birth was 2970±447 gr. Most of the patients were born as NVD (52.7%) and term (74.5%). The most common comorbidity was congenital heart disease. The most common short-term complication was intestinal obstruction in 14 patients (25.5%) and the most frequent long-term complication was intestinal obstruction and constipation (27.3% each cases). The mortality rate of patients in this study was 14.5% in total. Conclusions. One stage surgical procedure in Hirschsprung's disease is a safe and effective method, but care should be taken in choosing patients and patients should be monitored for possible complications, so that they can be considered and implemented for proper treatment.

scholarly journals Comparative study of Hsp27, GSK3β, Wnt1 and PRDX3 in Hirschsprung's disease

2014 ◽  
Vol 95 (3) ◽  
pp. 229-237 ◽  
Author(s):  
Hong Gao ◽  
Xiaomei Liu ◽  
Dong Chen ◽  
Liangying Lv ◽  
Mei Wu ◽  
...  
Keyword(s):  
Comparative Study ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease

Single stage laparoscopic treatment of Hirschprungs disease for childrend under 6 month old in Viet Duc hospital

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Việt Hoa Nguyễn
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Operating Time ◽  
Single Stage ◽  
Average Hospital ◽  
Conversion To Open Surgery ◽  
Stay Time ◽  
Average Operating Time ◽  
Pull Through ◽  
Laparoscopic Assisted

Tóm tắt Đặt vấn đề: Ứng dụng phẫu thuật nội soi ổ bụng kết hợp với đường qua hậu môn cắt đoạn đại trực tràng vô hạch ở trẻ 2 - 6 tháng tuổi tại khoa Nhi bệnh viện Việt Đức Phương pháp nghiên cứu: Nghiên cứu hồi cứu cho trẻ 2 - 6 tháng tuổi được chẩn đoán phình đại tràng bẩm sinh dựa vào lâm sàng, chụp đại tràng có thuốc cản quang và sinh thiết tức thì trong mổ. Phẫu thuật 1 thì, nội soi ổ bụng sử dụng 3 trocars phẫu tích đoạn đại tràng cần cắt bỏ, kết hợp đường qua hậu môn sử dụng van Lonestar bóc đoạn trực tràng trên đường lược khỏi thanh cơ phương pháp Soave, kéo đoạn đại tràng vô hạch ra ngoài qua hậu môn, cắt và nối đại tràng lành với ống hậu môn. Đánh giá kết quả theo tiêu chuẩn Wingspread 1984 Kết quả: Trong thời gian từ tháng 6/2014 đến tháng 6/2017 có 32 người bệnh được phẫu thuật nội soi, tuổi trung bình 3,5 tháng. Thời gian phẫu thuật trung bình 150 ± 40 phút. Thời gian nằm viện trung bình 7,4 ± 2,2 ngày. Đại tràng vô hạch vị trí xích ma 1/3 dưới 19 người bệnh (59,37%), xích ma 1/3 giữa 11 người bệnh (34,38%), xích ma 1/3 trên 2 người bệnh (6,25%). Không có trường hợp nào chuyển mổ mở. chảy máu nặng hay bục rò miệng nối sau mổ. Theo dõi sau mổ từ 3 tháng - 4 năm: Viêm quanh hậu môn 6 người bệnh (18,75%); viêm ruột 8 người bệnh (25%); són phân 5 người bệnh (15,62%); táo bón 1 người bệnh (3,12%). Đánh giá chức năng đại tiện rất tốt 68,75%, tốt 21,88%, trung bình 9,37%. Chưa có trường hợp mổ lại, Kết luận: Phẫu thuật nội soi ổ bụng kết hợp đường qua hậu môn cắt đoạn đại trực tràng vô hạch một thì ở trẻ nhỏ là phương pháp phẫu thuật an toàn, mang lại chức năng đại tiện tốt, đảm bảo thẩm mỹ. Abstract Introduction: Laparoscopic assisted endorectal colon pull-through for Hirschsprung's disease have been applied for children under 6 month old in Viet Duc hospital Material and Methods: Restrospective. Children from 2 to 6 month with diagnosis of Hirschsprung's disease by clinical, radiological symptoms and biopsy during operation. Laparoscopic assisted endorectal colon pull- through by using Lonestar valve for resection of colon and coloanal anastomosis. Functional defecation is assessed according to the standard of Wingspread 1984. Results: 32 patients during from 6/2014 to 6/2017. Mean age: 3,5 months old, average operating time: 150 ± 40 minutes, average hospital stay time: 7,4 ± 2,2 days. The aganglionics lower sigmoid segment in 19 patiens (59,37%), 1/3 middle sigmoid segment in 11 patiens (34,38%), sigmoid segment in 2 patiens (6,25%). Non bleeding during the operation, no conversion to open surgery, no anastomotic fistula. Follow – up postoperative from 3 months to 4 years peri-anal: infection 6 patients (18,75%), enterocolitis 8 patients (25%), fecal incontinence 5 patients (15,62%), constipation 1 patient (4,45%). Functional defecation assessement: very good 68,75; good 21,88; average 9,37%. No re- operation. Conclusion: Single stage laparoscopic assisted endorectal colon pull- through for Hirschsprung's disease in children under 6 month old is safe with good functional defecation assessement. Keyword: Hirschprung ‘s desease, laparoscopic, endorectal colon pull- through

scholarly journals Comparative Study between One Stage Total Transanal Endorectal Pullthrough and Assisted Transanal Soave for Treatment of Hirschsprung’s Disease

2015 ◽  
Vol 15 (2) ◽  
pp. 186-203
Author(s):  
Hisham H.Ahmed ◽  
Ayman M . Abd Elmofeed ◽  
Mohammed M. Abd Elwahab ◽  
Elsayed M. Kilany ◽  
Ayman A. Albaghdady
Keyword(s):  
Comparative Study ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
One Stage
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