Long-term outcomes of mini-invasive methods of surgical treatment of hirschprung's disease in children

SUMMARY

Introduction. Mini-invasive methods of treatment of Hirschsprung‘s disease (HD), namely the Transanal Endorectal Pull-Through (TEPT) technique with laparoscopic or without laparoscopic assistance, have been widely used in pediatric surgery. Many clinics in their studies have noticed positive features of a mini-invasive approach to the treatment of HD in comparison with classical methods, but long-term outcome of such operations in children are still discussed.

Aim: to study the long-term outcomes of mini-invasive methods of treatment of HD in children.

Materials and methods. The experience of using mini-invasive methods of surgical correction of HD in 221 children was analyzed. Among them – 156 (70.59 %) patients underwent TEPT without laparoscopic assistance and 65 (29.41 %) children underwent laparoscopic-assisted TEPT. The results of general clinical and specific (barium enema, anomanometry, histologic research, determination of acetylcholiesterase activity) research methods were used for diagnosis.

Results. In general, in 55 (24.89 %) of 221 patients who underwent TEPT for HD, in the long term there were postoperative intestinal problems - moderate stenosis of the coloanal anastomosis without delayed fecal discharge (1.81 %), constipation (4.07 %), partial fecal incontinence (9.05 %) and enterocolitis (EC) (9.96 %). All children with postoperative intestinal problems received conservative treatment. There was no need of repeated surgery for these patients.

Conclusions.The type of complications in the remote period after HD correction depends on the patient‘s age at the time of surgery, careful compliance with the technical features of the technique, consideration of the anatomical features of the disease, the presence and type of comorbidity. In 24.89 % of children with HD who are operated on by mini-invasive methods, persistent intestinal problems continue to take place in the remote period. The earlier HD correction is performed, the better functional results are in the long run.

Key words: Hirschsprung’s disease, children, mini-invasive methods, results.
Lek Obz, 2022, 71 (3): 111-115

Vasyl P. PRYTULA 1,2, Oleh O. KURTASH 3

1 Bogomolets National Medical University, Kyiv, Ukraine
2 National Children’s Specialized Hospital “OKHMATDYT”, Kyiv, Ukraine
3 Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine

Citácia:
Vasyl P. PRYTULA V.P., Oleh O. KURTASH O.O.: Výsledky dlhodobého sledovania mini-invazívnej chirurgickej liečby Hirschprungovej choroby u detí. Lek Obz, 2022, 71 (3): 111-115

Cite:
Vasyl P. PRYTULA V.P., Oleh O. KURTASH O.O.: Long-term outcomes of mini-invasive methods of surgical treatment of hirschprung's disease in children. Lek Obz, 2022, 71 (3): 111-115