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DOI: 10.1055/s-0030-1252006
© Georg Thieme Verlag KG Stuttgart · New York
Transanal Endorectal vs. Duhamel Pull-Through for Hirschsprung's Disease
Publikationsverlauf
received September 27, 2009
accepted after revision March 01, 2010
Publikationsdatum:
14. April 2010 (online)
![](https://www.thieme-connect.de/media/ejps/201004/lookinside/thumbnails/10.1055-s-0030-1252006-1.jpg)
Abstract
Introduction: The aim of this study was to test the hypothesis that the early functional outcome for patients with rectosigmoid Hirschsprung's disease (HD) is comparable for the Duhamel pull-through procedure and the transanal endorectal pull-through (TERPT) procedure, with less discomfort for the patient postoperatively after the TERPT technique.
Material and methods: Eleven patients operated on with the TERPT technique (T Group) were prospectively registered and compared retrospectively with 18 patients operated on with the Duhamel pull-through (D Group). Data recorded included patient demographics, operative treatment, complications, hospital stay and bowel functions. The follow-up time was limited to 24 months.
Results: The T Group started oral feeding sooner, their bowel movements started sooner and they had less need for analgesia postoperatively and a significantly shorter hospital stay. 71% of the patients in the D Group needed re-intervention compared to only 18% of the T Group. Enterocolitis was seen in two patients in both groups. At the last clinical control ten patients had constipation (59%) and three had soiling (18%) in the D Group. Three patients in the T Group had constipation (27%) and one had soiling (9%).
Conclusion: Our results support the use of the TERPT method rather than the Duhamel pull-through for rectosigmoid HD.
Key words
Hirschsprung's disease - aganglionosis - transanal pull-through - TERPT - Duhamel pull-through
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Correspondence
Dr. Anna GunnarsdóttirMD
Lund University Hospital
Dpt of Pediatric Surgery
Getingevägen 2
221 85 Lund
Sweden
Telefon: 0046 46178305
Fax: 0046 46172299
eMail: anna.gunnarsdottir@med.lu.se