A comparative study between transanal endorectal pull-through and Swenson transanal pull-through techniques in treatment of patient with Hirschsprung disease.

Nabil, Ahmed M.; Al-Tagy, Gamal H.; Kaddah, Sherif N.; Elsaket, Hesham M.; Mahmoud, Wessam M.; Nairoukh, Baker S.

doi:10.21608/EJSUR.2024.282388.1049

	A comparative study between transanal endorectal pull-through and Swenson transanal pull-through techniques in treatment of patient with Hirschsprung disease.
The Egyptian Journal of Surgery
Volume 43, Issue 4, October 2024, Page 1278-1284 PDF (835.1 K)
Document Type: Original Article
DOI: 10.21608/EJSUR.2024.282388.1049
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Authors
Ahmed M. Nabil^* ¹; Gamal H. Al-Tagy²; Sherif N. Kaddah²; Hesham M. Elsaket²; Wessam M. Mahmoud²; Baker S. Nairoukh³
¹Department of Pediatric Surgery, aFaculty of Medicine, Cairo University, Giza, bBenha Children Hospital, M.O.H, Benha, Al-Qalyubia, Egypt
²Department of Pediatric Surgery, Faculty of Medicine, Cairo University, Giza
³Department of Pediatric Surgery, Benha Children Hospital, M.O.H, Benha, Al-Qalyubia, Egypt
Abstract
Background: Hirschsprung (HD) disease is a relatively common neonatal developmental disorder of the enteric nervous system. Aim & Objectives: To study and compare the Soave and Swenson transanal endorectal pull-through procedures in HD patients. Regarding the operative and postoperative complications, time to return to full oral feeding, duration of hospital stay, and outcome. Patients and Methods: This prospective randomized study included 40 patients diagnosed with HD disease at the Pediatric Surgery unit, General Surgery department, Faculty of Medicine, at Cairo University Hospital and Benha Children Hospital from July 2014 to October 2016. Patients were randomly divided into two equal groups. Results: There was a highly statistically significant difference between the two groups as regards mean operative time P<0.001. There was no statistically significant difference between the two groups as regards blood transfusion, mean time to return to full oral feeding P= 0. 612, and mean postoperative hospital stay P= 0.574 only two cases in group B suffered from anal lacerations due to excessive traction by the retractor. There was no statistically significant difference between the two groups as regards late postoperative complications P=0.267. Conclusion: The Swenson Trans-anal pull-through, is a safe and effective alternative for the treatment of HD, with comparable results to the more established Soave procedure, also with shorter operative time, without increased incidence of urological problems, or intraoperative injury of surrounding vital structures. The technique can even be easier than the Soave procedure.
Keywords
Hirschsprung disease; swenson transanal pull-through; transanal endorectal pull through


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