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Is the Rehbein procedure obsolete in the treatment of Hirschsprung’s disease?

PURPOSE: After 25 years of practice and positive results of the Rehbein-procedure (RB) for children with Hirschsprung Disease (HD), we changed to the less invasive transanal endorectal pull through (TERPT). The aim of this study was to compare short- and mid-term complications of these two procedure...

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Autores principales: Visser, Reina, van de Ven, Teun J., van Rooij, Iris A. L. M., Wijnen, Rene M. H., de Blaauw, Ivo
Formato: Texto
Lenguaje:English
Publicado: Springer-Verlag 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2962790/
https://www.ncbi.nlm.nih.gov/pubmed/20734054
http://dx.doi.org/10.1007/s00383-010-2696-0
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author Visser, Reina
van de Ven, Teun J.
van Rooij, Iris A. L. M.
Wijnen, Rene M. H.
de Blaauw, Ivo
author_facet Visser, Reina
van de Ven, Teun J.
van Rooij, Iris A. L. M.
Wijnen, Rene M. H.
de Blaauw, Ivo
author_sort Visser, Reina
collection PubMed
description PURPOSE: After 25 years of practice and positive results of the Rehbein-procedure (RB) for children with Hirschsprung Disease (HD), we changed to the less invasive transanal endorectal pull through (TERPT). The aim of this study was to compare short- and mid-term complications of these two procedures in our patients with HD. METHODS: Retrospective data of 50 HD patients were analyzed. Of these patients, 25 underwent RB (2000–2006) and in 25 the TERPT was performed (2005–2009). Medical records were reviewed to score complications and outcomes. Differences were analyzed using Chi-Square and Mann–Whitney U tests. RESULTS: All RB patients (100%) were given a colostomy compared with four patients (16%) in the TERPT group (p < 0.001). The average age at surgery in the RB group was 191 days whereas this was 72 days in the TERPT group (p < 0.01). The mean length of time of surgery in the RB group (158 min) was not significantly different from that in the TERPT group (183 min). Ganglion cells were located in all specimens at the proximal end of the specimens. The median time to first feeding significantly decreased from 2 days (range 1–11) in the RB group to 1 day (range 1–3) in the TERPT group (p < 0.01). The median length of hospital stay decreased in the TERPT group (8 days) compared with the RB group (10 days) (p < 0.001). There was a significant reduction in postoperative obstructive symptoms during the first 6 months in the TERPT group (48%) compared with the RB group (84%) (p = 0.016). Postoperative enterocolitis decreased from 40% in the RB group to 24% in the TERPT group although this was not statistically significant. CONCLUSIONS: The introduction of TERPT reduced the need for colostomies; it shortened days to first feeding after surgery and reduced hospital stay. It also improved short-term outcome with less obstructive symptoms. We recommend TERPT surgery as a first choice in children with HD. we consider the RB now to be obsolete.
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spelling pubmed-29627902010-11-16 Is the Rehbein procedure obsolete in the treatment of Hirschsprung’s disease? Visser, Reina van de Ven, Teun J. van Rooij, Iris A. L. M. Wijnen, Rene M. H. de Blaauw, Ivo Pediatr Surg Int Original Article PURPOSE: After 25 years of practice and positive results of the Rehbein-procedure (RB) for children with Hirschsprung Disease (HD), we changed to the less invasive transanal endorectal pull through (TERPT). The aim of this study was to compare short- and mid-term complications of these two procedures in our patients with HD. METHODS: Retrospective data of 50 HD patients were analyzed. Of these patients, 25 underwent RB (2000–2006) and in 25 the TERPT was performed (2005–2009). Medical records were reviewed to score complications and outcomes. Differences were analyzed using Chi-Square and Mann–Whitney U tests. RESULTS: All RB patients (100%) were given a colostomy compared with four patients (16%) in the TERPT group (p < 0.001). The average age at surgery in the RB group was 191 days whereas this was 72 days in the TERPT group (p < 0.01). The mean length of time of surgery in the RB group (158 min) was not significantly different from that in the TERPT group (183 min). Ganglion cells were located in all specimens at the proximal end of the specimens. The median time to first feeding significantly decreased from 2 days (range 1–11) in the RB group to 1 day (range 1–3) in the TERPT group (p < 0.01). The median length of hospital stay decreased in the TERPT group (8 days) compared with the RB group (10 days) (p < 0.001). There was a significant reduction in postoperative obstructive symptoms during the first 6 months in the TERPT group (48%) compared with the RB group (84%) (p = 0.016). Postoperative enterocolitis decreased from 40% in the RB group to 24% in the TERPT group although this was not statistically significant. CONCLUSIONS: The introduction of TERPT reduced the need for colostomies; it shortened days to first feeding after surgery and reduced hospital stay. It also improved short-term outcome with less obstructive symptoms. We recommend TERPT surgery as a first choice in children with HD. we consider the RB now to be obsolete. Springer-Verlag 2010-08-24 2010 /pmc/articles/PMC2962790/ /pubmed/20734054 http://dx.doi.org/10.1007/s00383-010-2696-0 Text en © The Author(s) 2010 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Original Article
Visser, Reina
van de Ven, Teun J.
van Rooij, Iris A. L. M.
Wijnen, Rene M. H.
de Blaauw, Ivo
Is the Rehbein procedure obsolete in the treatment of Hirschsprung’s disease?
title Is the Rehbein procedure obsolete in the treatment of Hirschsprung’s disease?
title_full Is the Rehbein procedure obsolete in the treatment of Hirschsprung’s disease?
title_fullStr Is the Rehbein procedure obsolete in the treatment of Hirschsprung’s disease?
title_full_unstemmed Is the Rehbein procedure obsolete in the treatment of Hirschsprung’s disease?
title_short Is the Rehbein procedure obsolete in the treatment of Hirschsprung’s disease?
title_sort is the rehbein procedure obsolete in the treatment of hirschsprung’s disease?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2962790/
https://www.ncbi.nlm.nih.gov/pubmed/20734054
http://dx.doi.org/10.1007/s00383-010-2696-0
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