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Laparoscopic-Assisted Duhamel for Hirschsprung's Children Older than 3 Years

CONTEXT: Hirschsprung's disease (HD) is a congenital anomaly affecting the enteric nervous system commonly the rectosigmoid region. Treatment is surgical where the aganglionic segment is resected, and bowel continuity is achieved by a colo-anal anastomosis. In 1999, Georgeson et al. proposed a...

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Autores principales: Arafa, Ahmed, Eltantawi, Haytham Esmat, Ragab, Moutaz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759419/
https://www.ncbi.nlm.nih.gov/pubmed/34916348
http://dx.doi.org/10.4103/ajps.AJPS_1_21
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author Arafa, Ahmed
Eltantawi, Haytham Esmat
Ragab, Moutaz
author_facet Arafa, Ahmed
Eltantawi, Haytham Esmat
Ragab, Moutaz
author_sort Arafa, Ahmed
collection PubMed
description CONTEXT: Hirschsprung's disease (HD) is a congenital anomaly affecting the enteric nervous system commonly the rectosigmoid region. Treatment is surgical where the aganglionic segment is resected, and bowel continuity is achieved by a colo-anal anastomosis. In 1999, Georgeson et al. proposed a new technique of primary laparoscopic-assisted pull through for HD as a new gold standard. AIM OF THE STUDY: To evaluate the outcome of the laparoscopic Duhamel procedure for the management of HD in children older than 3 years. METHODS: This study was performed on 8 patients who were more than 3-year-old, with confirmed diagnoses of HD. Patients who initially presented with enterocolitis or obstruction were excluded from this study. In all cases, laparoscopic-assisted Duhamel was done. RESULTS: We reported our results for the 1(st) year follow-up period and divided our results into early outcome for the first 3 months postoperative during which we had 2 cases complaining of enterocolitis that responded to conservative treatment, we observed 2 cases of perianal excoriation that responded to medical treatment while the late outcome was reported after 3 months postoperative: We had two cases with attacks of enterocolitis at 6 months and 9 months postoperatively that needed conservative treatment in the hospital in the form of parenteral antibiotics, rectal irrigation, intravenous fluids and NP0. There was neither anastomotic leak nor stenosis. CONCLUSION: Laparoscopic Duhamel for the management of HD in children older than 3 years is safe and useful procedure.
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spelling pubmed-87594192022-01-21 Laparoscopic-Assisted Duhamel for Hirschsprung's Children Older than 3 Years Arafa, Ahmed Eltantawi, Haytham Esmat Ragab, Moutaz Afr J Paediatr Surg Original Article CONTEXT: Hirschsprung's disease (HD) is a congenital anomaly affecting the enteric nervous system commonly the rectosigmoid region. Treatment is surgical where the aganglionic segment is resected, and bowel continuity is achieved by a colo-anal anastomosis. In 1999, Georgeson et al. proposed a new technique of primary laparoscopic-assisted pull through for HD as a new gold standard. AIM OF THE STUDY: To evaluate the outcome of the laparoscopic Duhamel procedure for the management of HD in children older than 3 years. METHODS: This study was performed on 8 patients who were more than 3-year-old, with confirmed diagnoses of HD. Patients who initially presented with enterocolitis or obstruction were excluded from this study. In all cases, laparoscopic-assisted Duhamel was done. RESULTS: We reported our results for the 1(st) year follow-up period and divided our results into early outcome for the first 3 months postoperative during which we had 2 cases complaining of enterocolitis that responded to conservative treatment, we observed 2 cases of perianal excoriation that responded to medical treatment while the late outcome was reported after 3 months postoperative: We had two cases with attacks of enterocolitis at 6 months and 9 months postoperatively that needed conservative treatment in the hospital in the form of parenteral antibiotics, rectal irrigation, intravenous fluids and NP0. There was neither anastomotic leak nor stenosis. CONCLUSION: Laparoscopic Duhamel for the management of HD in children older than 3 years is safe and useful procedure. Wolters Kluwer - Medknow 2022 2021-12-14 /pmc/articles/PMC8759419/ /pubmed/34916348 http://dx.doi.org/10.4103/ajps.AJPS_1_21 Text en Copyright: © 2022 African Journal of Paediatric Surgery https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Arafa, Ahmed
Eltantawi, Haytham Esmat
Ragab, Moutaz
Laparoscopic-Assisted Duhamel for Hirschsprung's Children Older than 3 Years
title Laparoscopic-Assisted Duhamel for Hirschsprung's Children Older than 3 Years
title_full Laparoscopic-Assisted Duhamel for Hirschsprung's Children Older than 3 Years
title_fullStr Laparoscopic-Assisted Duhamel for Hirschsprung's Children Older than 3 Years
title_full_unstemmed Laparoscopic-Assisted Duhamel for Hirschsprung's Children Older than 3 Years
title_short Laparoscopic-Assisted Duhamel for Hirschsprung's Children Older than 3 Years
title_sort laparoscopic-assisted duhamel for hirschsprung's children older than 3 years
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759419/
https://www.ncbi.nlm.nih.gov/pubmed/34916348
http://dx.doi.org/10.4103/ajps.AJPS_1_21
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