scholarly journals One stage transanal full thickness pull-through operation for rectosigmoid Hirschsprung's disease

2016 ◽  
Vol 9 (3) ◽  
pp. 135
Author(s):  
A. K. M. Zahid Hossain ◽  
Gazi Zahirul Hasan ◽  
Susankar Kumar Mandal ◽  
Md. Nooruzzaman ◽  
A. Shahinoor ◽  
...  
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Bowel Movement ◽  
Long Term Results ◽  
Full Thickness ◽  
Urinary Function ◽  
One Stage ◽  
Pull Through

<p>The surgical management of Hirschsprung's disease (HD) has changed from the original staged operations to the latest introduced minimally invasive one stage techniques. One stage transanal full thickness Swenson-like procedure is a new concept of single stage procedure for HD. We reviewed the early outcome of one stage transanal Swenson-like pull-through operation for rectosigmoid HD. By using the transanal concept we choose to apply Swenson's principle in transanal dissection for the primary treatment of HD and describe technical aspects and impact on fecal and urinary function. We reviewed our series of HD patient who underwent one-stage transanal full thickness, Swenson-like rectosigmoid dissection, assessing for postoperative stricture or stenosis, anastomotic leak, enterocolitis, obstruction and long-term results for bowel and urinary function. Of 15 patients all had the transanal resection, the age of the patients ranged from 6 months to 5 years. The average length of resection was 20 ± 5 cm. Mean follow-up was 24 months. 10 patients were at least three years old at follow-up and were assessed for urinary and fecal continence. All had the voluntary bowel movement and urinary continence. Three patients had episodes of postoperative enterocolitis and two patients developed stenosis at the anastomotic site. Postoperative frequent bowel movement was present in all patients and continued for 2-8 weeks. In conclusion, our data support the fact that a modification of Swenson's original transabdominal dissection concept using the recently describe transanal approach is an excellent technique for HD and produces excellent long-term outcome for fecal and urinary function.</p><p> </p>

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

2000 ◽  
Vol 35 (6) ◽  
pp. 829-834 ◽  
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

scholarly journals The follow-up of the robotic-assisted Soave procedure for Hirschsprung’s disease in children

2021 ◽  
Author(s):  
Tran Anh Quynh ◽  
Pham Duy Hien ◽  
Le Quang Du ◽  
Le Hoang Long ◽  
Nguyen Thi Ngoc Tran ◽  
...  
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Pediatric Patients ◽  
Three Dimensional ◽  
Dentate Line ◽  
Robotic Arms ◽  
Robotic Assisted ◽  
The Mean ◽  
Pull Through

AbstractRobotic surgery offers three-dimensional visualization and precision of movement that could be of great value to gastrointestinal surgeons. There were many previous reports on robotic technology in performing Soave colonic resection and pull-through for Hirschsprung’s disease in children. This study described the follow-up of the Robotic-assisted Soave procedure for Hirschsprung’s disease in children. Robotic-assisted endorectal pull-through was performed using three robotic arms and an additional 5-mm trocar. The ganglionic and aganglionic segments were initially identified by seromuscular biopsies. The rest of the procedure was carried out according to the Soave procedure. We left a short rectal seromuscular sleeve of 1.5–2 cm above the dentate line. From December 2014 to December 2017, 55 pediatric patients were operated on. Age ranged from 6 months to 10 years old (median = 24.5 months). The aganglionic segment was located in the rectum (n = 38), the sigmoid colon (n = 13), and the left colon (n = 4). The mean total operative time was 93.2 ± 35 min (ranging from 80 to 180 min). Minimal blood was lost during the surgery. During the follow-up period, 41 patients (74.6%) had 1–2 defecations per day, 12 patients (21.8%) had 3–4 defecations per day, and 2 patients (3.6%) had more than 4 defecations per day. Fecal incontinence, enterocolitis, and mild soiling occurred in three (5.4%), four (7.3%), and two pediatric patients, respectively. Robotic-assisted Soave procedure for Hirschsprung’s disease in children is a safe and effective technique. However, a skilled robotic surgical team and procedural modifications are needed.

Long-Term Outcomes and Quality of Life in Patients after Soave Pull-Through Operation for Hirschsprung's Disease: An Observational Retrospective Study

2017 ◽  
Vol 28 (05) ◽  
pp. 445-454 ◽  
Author(s):  
Tania Mahler ◽  
Martine Dassonville ◽  
Dinh Truong ◽  
Annie Robert ◽  
Philippe Goyens ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fecal Incontinence ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Bowel Function ◽  
Long Term Outcomes ◽  
Neurologic Impairment ◽  
Pull Through

Introduction Patients after pull-through operation for Hirschsprung's disease (HD) are at high risk of defecation disorders. This study aimed at investigating their long-term outcomes and quality of life (QoL) in comparison with controls. Patients and Methods Patients older than 5 years operated on for HD were interviewed to complete detailed questionnaires on bowel function. Patients without neurologic impairment were enrolled in a QoL survey to compare with controls matched for sex and age and selected randomly from the general population using sampling set in a ratio of four controls to one case of HD. Results In total, 53 operated patients were enrolled. Mean age of the patients was 16 ± 8 years, with 68% boys. Rectosigmoid aganglionosis was the most seen form of HD in 38 (72%) cases. Open Soave was performed in 40 (75.5%) cases, and minimally invasive surgery Soave (MIS Soave) in 13 (24.5%) cases. At investigation, prevalence of fecal incontinence and constipation were 22.6 and 13.2%, respectively. Regarding QoL survey, 45 patients and 180 controls were enrolled, excluding 8 patients with neurologic impairment. Thirty-seven (82.2%) patients were classified as having a good QoL (score ≥ 9 points); whereas six had a fair QoL (5–8 points) and two had a poor QoL (< 5 points). QoL score in the cases and the controls were 10.2 ± 2.5 and 11.9 ± 0.4 points, respectively. Long aganglionosis form of HD was significantly associated with a low QoL (score < 8 points), adjusted odds ratio = 9, 95% confidence interval [1.3; 64.1] (p < 0.05). In subscales analyses, the prevalence of each dimension including fecal continence, school absenteeism, unhappiness or anxiety, food restriction, and peer rejection was significantly higher in operated patients than in controls (p <0.001). Conclusion Although the QoL of patients operated on for HD in general was with good outcomes, fecal incontinence and constipation still are problematic issues and challenges in a high percentage of patients. Therefore, a long-term and multidisciplinary follow-up is essentially required for these patients.

scholarly journals Interest of Anorectal Manometry During Long-term Follow-up of Patients Operated on for Hirschsprung's Disease

2018 ◽  
Vol 24 (1) ◽  
pp. 70-78 ◽  
Author(s):  
Viet Q Tran ◽  
Tania Mahler ◽  
Patrick Bontems ◽  
Dinh Q Truong ◽  
Annie Robert ◽  
...  
Keyword(s):  
Anorectal Manometry ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Long Term Follow Up

Results at 10–24 years after single-stage revision arthroplasty of infected total hip arthroplasty in patients under 45 years of age

2019 ◽  
pp. 112070001988887 ◽  
Author(s):  
Matthias Wolff ◽  
Christian Lausmann ◽  
Thorsten Gehrke ◽  
Akos Zahar ◽  
Malte Ohlmeier ◽  
...  
Keyword(s):  
Infection Control ◽  
Revision Surgery ◽  
Single Stage ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Study Cohort ◽  
One Stage ◽  
The Mean

Introduction: The management of periprosthetic joint infection (PJI) of the hip is a challenging procedure. One-stage exchange is carried out in specialist centres with comparable infection free survival rates. However, there is a paucity of long-term results of this approach in young patients. Methods: All patients undergoing one-stage exchange due to PJI with a known causative organism ⩽45 years of age with a minimum of 10-year follow-up (mean 15 years; range 10–24 years) were enrolled in this retrospective study. Patients older than 45 years of age or patients with a two-stage procedure were excluded from the study. The primary outcome measure was failure rate with special focus on reinfection at latest follow-up. Failure was defined as revision surgery for infection. Furthermore, functional outcome using the Harris Hip Score was determined initially and at latest follow-up. 26 patients fulfilled the inclusion criteria and were available for final follow-up. Results: The study cohort consists of 16 male and 10 female patients with a mean age of 36.8 years (range 20–45 years) and a mean BMI of 29.8 kg/m2 (range 20.7–40.6 kg/m2). Prior to the single-stage procedure, the patients underwent an average of 3.1 previous surgical interventions (range 1–9). The mean hospital stay after septic revision was 19.7 days (11–33 days). Most infections were caused by Staphylococcus epidermidis ( n = 8, 30.8%), followed by Staph. aureus ( n = 7, 26.9%) and Propionibacterium acnes ( n = 6, 23.1%). At latest follow-up, the overall survival rate was 76.9 %, while infection control could be achieved in 96.2%. At final examination, the mean Harris Hip Score improved from 46.2 to 78.9 (range 18.0–99; SD, 22.6). Conclusions: Single-stage revision surgery for the management of PJI in patients ⩽45 years is a successful treatment option with high infection control, even after long-term follow-up.

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