Literature Review of the Frequency of Reoperations after One Stage Transanal Endorectal Pull-Through Procedure for Hirschsprung’s Disease in Children

Abstract

Background: Transanal endorectal one-stage pull-through (TERPT) procedure in children with Hirschsprung’s disease (HD) has gained worldwide acceptance. However surgical success is often reported separately, while the necessity for true reoperation is difficult to establish. Aim: To evaluate the incidence of reoperations following TERPT procedure. The findings will be important in counseling and planning childcare for HD patients as well as providing a benchmark for single centers clinical results. Methods: A literature review of reported TERPT operations on children with HD between 1998 through 2011 was performed. Only planned TERPT operation reports were included. Information was collected with particular emphasis on reoperations and their reasons. Results: Out of 26 published articles 23 were included, reporting on 836 children, female/male ratio: 1/3.3, undergoing the TERPT procedure as the only operative intervention with described postoperative courses. The children comprised neonates, <4 weeks (38%), babies <1 year (35%), toddlers, 1 - 3 years (15%) and children >3 years of age (12%). The average follow up was 18.5 (6 - 38) months. The resected bowel length mean was 20.5 cm. Forty-one reoperations were reported (4.9%), including 24 laparotomies, 8 laparoscopies, 6 colostomies and ileostomies in 3 children. Only 2 re-do TERPT were reported (0.2%). Seven patients were considered TERPT failures (0.8%) with 5 requiring diverting colostomies and additional transabdominal pull-through operations. Two myectomies were performed (0.2%). One child with aganglionosis underwent a Duhamel pull through. Two (0.2%) had serious damage to the urinary tract also one child with a vas deferens lesion was reoperated. Two bowel obstructions required adhesiolysis. Eight anastomotic dehiscences (0.9%) required surgery after reparation. One prolapse of the pulled through colon was reported. Six patients (0.7%) suffered anastomotic leaks. Anastomotic strictures rate was 2.8%, all repaired with anal dilatation. Conclusion: The review supports the low incidence of reported reoperations for the TERPT procedure.

Share and Cite:

C. Lopera, P. Stenström, M. Anderberg and E. Arnbjörnsson, "Literature Review of the Frequency of Reoperations after One Stage Transanal Endorectal Pull-Through Procedure for Hirschsprung’s Disease in Children," Surgical Science, Vol. 3 No. 6, 2012, pp. 290-294. doi: 10.4236/ss.2012.36058.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] L. De la Torre-Mondragón and J. A. Ortega-Salgado, “Transanal Endorectal Pull-Through for Hirschsprung’s Disease,” Journal of Pediatric Surgery, Vol. 34 No. 3, 1998, pp. 1283-1286.
[2] A. Gunnarsdóttir, L. T. Larsson and E. Arnbj?rnsson, “Transanal Endorectal vs. Duhamel Pull-Through for Hirschsprung’s Disease,” European Journal of Pediatric Surgery, Vol. 20, No. 4, 2010, pp. 242-246.
[3] A. C. Tannuri, U. Tannuri and R. L. Rom?o, “Transanal Endorectal Pull-Through in Children with Hirschsprung’s Disease—Technical Refinements and Comparison of Results with the Duhamel Procedure,” Journal of Pediatric Surgery, Vol. 44, No. 4, 2009, pp. 767-772. doi:10.1016/j.jpedsurg.2008.08.002
[4] C. T. Albanese, R. W. Jennings, B. Smith, B. Bratton and M. R. Harrison, “Perineal One-Stage Pull-Through for Hirschsprung’s Disease,” Journal of Pediatric Surgery, Vol. 34, No. 3, 1999, pp. 377-380. doi:10.1016/S0022-3468(99)90480-3
[5] M. K. Aslan, I. Karaman, A. Karaman, D. Erdo?an, Y. H. Cavu?o?lu and O. Cakmak, “Our Experience with Transanal Endorectal Pull-Through in Hirschsprung’s Disease,” European Journal of Pediatric Surgery, Vol. 42, No. 7, 2007, pp. 335-339. doi:10.1055/s-2007-965447
[6] O. Ate?, G. Hakgüder, Y. Kart, M. Olguner and F. M. Akgür, “The Effect of Dilated Ganglionic Segment on Anorectal and Urinary Functions During 1-Stage Transanal Endorectal Pull through for Hirschsprung’s Disease,” Journal of Pediatric Surgery, Vol. 42, No.7, 2007, pp. 1271-1275.
[7] L. De la Torre and A. Ortega, “Transanal versus Open Endorectal Pull-Through for Hirschsprung’s Disease,” Journal of Pediatric Surgery, Vol. 35, No. 8, 2000, pp. 1630-1632. doi:10.1053/jpsu.2000.18338
[8] G. Ekema, D. Falchetti, F. Torri, V. E. Merulla, A. Manciana and G. Caccia, “Further Evidence on Totally Transanal One-Stage Pull-Through Procedure for Hirschsprung’s Disease,” Journal of Pediatric Surgery, Vol. 38, No. 10, 2003, pp. 1434-1439. doi:10.1016/S0022-3468(03)00492-5
[9] Y. Gao, G. Li, X. Zhang, Q. Xu, Z. Guo, B. Zheng and P. Li, G. Li, “Primary Transanal Rectosigmoidectomy for Hirschsprung’s Disease: Preliminary Results in the Initial 33 Cases,” Journal of Pediatric Surgery, Vol. 36, No. 12, 2001, pp. 1816-1819. doi:10.1053/jpsu.2001.28847
[10] A. Hadidi, “Transanal Endorectal Pull-Through for Hirschsprung’s Disease: Experience with 68 Patients,” Journal of Pediatric Surgery, Vol. 38, No. 9, 2003, pp. 1337-1340. doi:10.1016/S0022-3468(03)00392-0
[11] M. E. H?llwarth, M. Rivosecchi, J. Schleef, S. Deluggi, G. Fasching, E. Ceriati, G. Ciprandi and F. DePeppo, “The Role of Transanal Endorectal Pull-Through in the Treatment of Hirschsprung’s Disease—A Multicenter Experience,” Pediatric Surgery International, Vol. 18, No. 5-6, 2002, pp. 344-348.
[12] Y. Huang, S. Zheng and X. Xiao, “A Follow-Up Study on Postoperative Function after a Transanal Soave 1-Stage Endorectal Pull-Through Procedure for Hirschsprung’s Disease,” Journal of Pediatric Surgery, Vol. 43, No. 9, 2008, pp. 1691-1695. doi:10.1016/j.jpedsurg.2007.12.053
[13] I. Jester, S. Holland-Cunz, S. Loff, S. Hosie, K. Reinshagen, H. Wirth, M. Ali and K. L. Waag, “Transanal Pull-Through Procedure for Hirschsprung’s Disease: A 5-Year Experience,” European Journal of Pediatric Surgery, Vol. 19, No. 2, 2009, pp. 68-71. doi:10.1055/s-2008-1039052
[14] D. D. Jovanovi?, V. A. Milojkovi?, Z. M. Stevanovi? and M. M. Vukadin, “Transanal One-Stage Endorectal Technique for Hirschprung’s Disease—A Preliminary Report of 24 Cases from a Single Institution,” Acta chirurgica iugoslavica, Vol. 56, No. 1, 2009, pp. 109-113. doi:10.2298/ACI0901109J
[15] H. Y. Kim and J. T. Oh, “Stabilization Period after 1-Stage Transanal Endorectal Pull-Through Operation for Hirschsprung’s Disease,” Journal of Pediatric Surgery, Vol. 44, No. 9, 2009, pp. 1799-1804. doi:10.1016/j.jpedsurg.2008.10.070
[16] J. C. Langer, A. C. Durrant, L. de la Torre, D. H. Teitelbaum, R. K. Minkes, M. G. Caty, B. E. Wildhaber, S. J. Ortega, S. Hirose and C. T. Albanese, “One-Stage Transanal Soave Pull-Through for Hirschsprung’s Disease: A Multicenter Experience with 141 Children,” Annals of Surgery, Vol. 238, No. 4, 2003, pp. 569-583.
[17] A. Nasr and J. C. Langer, “Evolution of the Technique in the Transanal Pull-Through for Hirschsprung’s Disease: Effect on Outcome,” Journal of Pediatric Surgery, Vol. 42, No. 1, 2007, pp. 36-39. doi:10.1016/j.jpedsurg.2006.09.028
[18] F. Obermayr, P. Szavay, R. Beschorner and J. Fuchs, “Outcome of Transanal Endorectal Pull-Through in Patients with Hirschsprung’s Disease,” European Journal of Pediatric Surgery, Vol. 19, No. 4, 2009, pp. 220-223. doi:10.1055/s-0029-1220682
[19] A. Pratap, D. K. Gupta, V. C. Shakya, S. Adhikary, A. Tiwari, P. Shrestha, S. R. Pandey and R. K. Yadav, “Analysis of Problems, Complications, Avoidance and Management with Transanal Pull-Through for Hirschsprung’s Disease,” Journal of Pediatric Surgery, Vol. 42, No. 11, 2007, pp. 1869-1876. doi:10.1016/j.jpedsurg.2007.07.017
[20] A. Pratap, V. C. Shakya, B. K. Biswas, A. Sinha, A. Tiwari, C. S. Agrawal and S. Adhikary, “Single-Stage Transanal Endorectal Pull-Through for Hirschsprung’s Disease: Perspective from a Developing Country,” Journal of Pediatric Surgery, Vol. 42, No. 3, 2007, pp. 532-535. doi:10.1016/j.jpedsurg.2006.10.049
[21] R. J. Rintala, “Transanal Coloanal Pull-Through with a Short Muscular Cuff for Classic Hirschsprung’s Disease,” European Journal of Pediatric Surgery, Vol. 13, No. 3, 2003, pp. 181-186.
[22] E. Sapin, A. Centonze, R. Moog, J. Borgnon and F. Becmeur, “Transanal Coloanal Anastomosis for Hirschsprung’s Disease: Comparison between Endorectal and Perirectal Pull-Through Procedures,” European Journal of Pediatric Surgery, Vol. 16 No. 5, 2006, pp. 312-317. doi:10.1055/s-2006-924523
[23] S. Teeraratkul, “Transanal One-Stage Endorectal Pull-Through for Hirschsprung’s Disease in Infants and Children,” Journal of Pediatric Surgery, Vol. 38, No. 2, 2003, pp. 184-187. doi:10.1053/jpsu.2003.50039
[24] Vijaykumar, A. Chattopadhyay, R. Patra and M. Murulaiah, “Soave Procedure for Infants with Hirschsprung’s Disease,” Indian Journal of Pediatrics, Vol. 69, No. 7, 2002, pp. 571-572. doi:10.1007/BF02722679
[25] T. Wester and R. J. Rintala, “Early Outcome of Transanal Endorectal Pull-Through with a Short Muscle Cuff during the neonatal period,” Journal of Pediatric Surgery, Vol. 39, No. 2. 2004, pp. 157-160. doi:10.1016/j.jpedsurg.2003.10.007
[26] A. Yamataka, K. Kaneyama, N. Fujiwara, Y. Hayashi, G. J. Lane, K. Kawashima and T. Okazaki, “Rectal Mucosal Dissection during Transanal Pull-Through for Hirschsprung’s Disease: The Anorectal or the Dentate Line?” Journal of Pediatric Surgery, Vol. 44, No. 1, 2009, pp. 266-269. doi:10.1016/j.jpedsurg.2008.10.054
[27] S. C. Zhang, Y. Z. Bai, W. Wang and W. L. Wang, “Clinical Outcome in Children after Transanal 1-Stage Endorectal Pull-Through Operation for Hirschsprung’s Disease,” Journal of Pediatric Surgery, Vol. 40, No. 8, 2005, pp. 1307-1311. doi:10.1016/j.jpedsurg.2005.05.016
[28] A. Pe?a, M. Elicevik and M. A. Levitt, “Reoperations in Hirschsprung’s Disease,” Journal of Pediatric Surgery, Vol. 42, No. 6, 2007, pp. 1008-1013. doi:10.1016/j.jpedsurg.2007.01.035
[29] E. A. Elhalaby, A. Hashish, M. M. Elbarbary, H. A. Soliman, M. K. Wishahy, A. Elkholy, S. Abdelhay, M. Elbehery, N. Halawa, T. Gobran, S. Shehata, N. Elkhouly and A. F. Hamza, “Transanal One-Stage Endorectal Pull-Through for Hirschsprung’s Disease: A Multicenter Study,” Journal of Pediatric Surgery, Vol. 39, No. 3, 2004, pp. 345-351. doi:10.1016/j.jpedsurg.2003.11.038
[30] E. Ruttenstock and P. Puri, “Systematic Review and Meta-Analysis of Enterocolitis after One-Stage Transanal Pull-Through Procedure for Hirschsprung’s Disease,” Pediatric Surgery International, Vol. 26, No. 11, 2010, pp. 1101-1105. doi:10.1007/s00383-010-2695-1

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.