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Assessment of Patients with Hirschsprung Disease and the Use of Laparoscopy

OBJECTIVES: This study aims to evaluate patients who were diagnosed and treated due to Hirschsprung disease (HD) in our clinic. METHODS: We retrospectively evaluated the demographic and clinical findings of the patients with HD, who were operated in our clinic between January 2010 and December 2015....

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Autores principales: Demir, Mesut, Akin, Melih, Kaba, Meltem, Genc, Nimetullah Mete, Sever, Nihat, Karadag, Cetin Ali, Dokucu, Ali Ihsan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kare Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326675/
https://www.ncbi.nlm.nih.gov/pubmed/32617062
http://dx.doi.org/10.14744/SEMB.2018.84565
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author Demir, Mesut
Akin, Melih
Kaba, Meltem
Genc, Nimetullah Mete
Sever, Nihat
Karadag, Cetin Ali
Dokucu, Ali Ihsan
author_facet Demir, Mesut
Akin, Melih
Kaba, Meltem
Genc, Nimetullah Mete
Sever, Nihat
Karadag, Cetin Ali
Dokucu, Ali Ihsan
author_sort Demir, Mesut
collection PubMed
description OBJECTIVES: This study aims to evaluate patients who were diagnosed and treated due to Hirschsprung disease (HD) in our clinic. METHODS: We retrospectively evaluated the demographic and clinical findings of the patients with HD, who were operated in our clinic between January 2010 and December 2015. RESULTS: During study period, 28 patients (19 male 9 female) were found to be operated due to HD in our clinic. Mean age was 16.8 months (1-168). “Transanal Endorectal Pull–through (TERPT)” was performed to 20 of them, Duhamell procedure to five and Soave procedure to three of them. TERPT was applied as laparoscopy assisted in four of them and biopsies were taken laparoscopically preoperatively from one of the patients from each group. Soave procedure was performed in three patients; one had anal stenosis and history of recurrent enterocolitis after TERPT procedure and pathologic analysis revealed neuronal intestinal dysplasia and the other one had total colonic HD and performed Soave procedure with colonic patch. Seven (25%) patients had enterocolitis. Frequencies of enterocolitis were three in two patients, two in two patients and one in three patients. Broad spectrum anibiotics and rectal washouts were supplied to these patients. Five of the seven patients with enterocolitis were operated with TERPT; two patients were operated with Duhamell procedure. Only one of them had total colonic HD. Three patients had total colonic HD diagnosis. Two of them were operated with Duhamell-Martin procedure and one was with Soave procedure with colonic patch according to Kimura technique. Anal stenosis developed in two patients after TERPT and treated with dilatations. Soiling rate was 3% (1/28) and this single patient was treated with laxatives and toilet training. Mean duration of hospitalization was 8.75 (2-14) days. Mean length of the removed intestinal segment was 23.6 (5-38) cm. Mean follow-up was for 35.5 (2-56) months. Neither of the patients was followed in the intensive care unit postoperatively nor died. CONCLUSION: TERPT procedure win priority in HD, but other procedures keep importance. Recently, laparoscopy-assisted TERPT is preferred in our clinic in HD therapy due to easy biopsy, full exposure to the transitional zone, the advantage of meso preparation of colon and prevention of strained anastomosis.
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spelling pubmed-73266752020-07-01 Assessment of Patients with Hirschsprung Disease and the Use of Laparoscopy Demir, Mesut Akin, Melih Kaba, Meltem Genc, Nimetullah Mete Sever, Nihat Karadag, Cetin Ali Dokucu, Ali Ihsan Sisli Etfal Hastan Tip Bul Original Research OBJECTIVES: This study aims to evaluate patients who were diagnosed and treated due to Hirschsprung disease (HD) in our clinic. METHODS: We retrospectively evaluated the demographic and clinical findings of the patients with HD, who were operated in our clinic between January 2010 and December 2015. RESULTS: During study period, 28 patients (19 male 9 female) were found to be operated due to HD in our clinic. Mean age was 16.8 months (1-168). “Transanal Endorectal Pull–through (TERPT)” was performed to 20 of them, Duhamell procedure to five and Soave procedure to three of them. TERPT was applied as laparoscopy assisted in four of them and biopsies were taken laparoscopically preoperatively from one of the patients from each group. Soave procedure was performed in three patients; one had anal stenosis and history of recurrent enterocolitis after TERPT procedure and pathologic analysis revealed neuronal intestinal dysplasia and the other one had total colonic HD and performed Soave procedure with colonic patch. Seven (25%) patients had enterocolitis. Frequencies of enterocolitis were three in two patients, two in two patients and one in three patients. Broad spectrum anibiotics and rectal washouts were supplied to these patients. Five of the seven patients with enterocolitis were operated with TERPT; two patients were operated with Duhamell procedure. Only one of them had total colonic HD. Three patients had total colonic HD diagnosis. Two of them were operated with Duhamell-Martin procedure and one was with Soave procedure with colonic patch according to Kimura technique. Anal stenosis developed in two patients after TERPT and treated with dilatations. Soiling rate was 3% (1/28) and this single patient was treated with laxatives and toilet training. Mean duration of hospitalization was 8.75 (2-14) days. Mean length of the removed intestinal segment was 23.6 (5-38) cm. Mean follow-up was for 35.5 (2-56) months. Neither of the patients was followed in the intensive care unit postoperatively nor died. CONCLUSION: TERPT procedure win priority in HD, but other procedures keep importance. Recently, laparoscopy-assisted TERPT is preferred in our clinic in HD therapy due to easy biopsy, full exposure to the transitional zone, the advantage of meso preparation of colon and prevention of strained anastomosis. Kare Publishing 2020-06-15 /pmc/articles/PMC7326675/ /pubmed/32617062 http://dx.doi.org/10.14744/SEMB.2018.84565 Text en Copyright: © 2020 by The Medical Bulletin of Sisli Etfal Hospital http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).
spellingShingle Original Research
Demir, Mesut
Akin, Melih
Kaba, Meltem
Genc, Nimetullah Mete
Sever, Nihat
Karadag, Cetin Ali
Dokucu, Ali Ihsan
Assessment of Patients with Hirschsprung Disease and the Use of Laparoscopy
title Assessment of Patients with Hirschsprung Disease and the Use of Laparoscopy
title_full Assessment of Patients with Hirschsprung Disease and the Use of Laparoscopy
title_fullStr Assessment of Patients with Hirschsprung Disease and the Use of Laparoscopy
title_full_unstemmed Assessment of Patients with Hirschsprung Disease and the Use of Laparoscopy
title_short Assessment of Patients with Hirschsprung Disease and the Use of Laparoscopy
title_sort assessment of patients with hirschsprung disease and the use of laparoscopy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326675/
https://www.ncbi.nlm.nih.gov/pubmed/32617062
http://dx.doi.org/10.14744/SEMB.2018.84565
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