Ju Yeon Lee, Jung-Hyun Choi, Jung-Man Namgung, D. Kim, Sungwon Kim
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The operation time of SSPT was shorter than Duhamel operation (145.0±37.0 minutes vs. 193.0±36.0 minutes, p<0.001). The mean follow-up period of SSPT and two-stage operation was 35.5±34.9 months (range, 2-132 months) and 56.6±35.5 months (range, 1-121 months), respectively. Defecation problem rate such as fecal soiling or fecal impaction showed no significant difference between the two groups (p=0.719). Two SSPT patients required botulinum toxin injection due to rectal stenosis. Three patients of SSPT group underwent re-do endorectal pull-through due to remnant aganglionic or hypoganglionic bowel. Conclusion: The SSPT showed shorter hospital days. However, few patients experienced rectal stenosis, but were manageable with botulinum toxin injection. The SSPT requires experienced-pathologist, as well as surgeon, because intra-operation pathology reading is critical for appropriate SSPT. SSPT is a feasible and reasonable option to treat Hirschsprung’s disease.","PeriodicalId":164943,"journal":{"name":"Journal of Korean Association of Pediatric Surgeons","volume":"42 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Single Stage Transanal Endorectal Pull-through Operation for Hirschsprung’s Disease in Neonate: A Single Center Experience\",\"authors\":\"Ju Yeon Lee, Jung-Hyun Choi, Jung-Man Namgung, D. Kim, Sungwon Kim\",\"doi\":\"10.13029/JKAPS.2016.22.2.38\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Purpose: The single stage transanal pull-through (SSPT) for Hirschsprung’sdisease is becoming the most popular procedure. This single center study compared the result of single stage operation with two-stage operation for Hirschsprung’s disease in neonates. Methods: We retrospectively reviewed medical records of all patients who were diagnosed as Hirschsprung’s disease and underwent SSPT or two-stage operation operation in Asan Medical Center between January 2003 and July 2014. Results: There were 17 SSPT and 28 two-stage operation. The mean age of SSPT group was 14.2±7.1 days, and the mean age of two-stage operation group was 15.4±8.6 days for stomy formation, and 188.6±36.3 days for Duhamel operation. The operation time of SSPT was shorter than Duhamel operation (145.0±37.0 minutes vs. 193.0±36.0 minutes, p<0.001). The mean follow-up period of SSPT and two-stage operation was 35.5±34.9 months (range, 2-132 months) and 56.6±35.5 months (range, 1-121 months), respectively. Defecation problem rate such as fecal soiling or fecal impaction showed no significant difference between the two groups (p=0.719). Two SSPT patients required botulinum toxin injection due to rectal stenosis. Three patients of SSPT group underwent re-do endorectal pull-through due to remnant aganglionic or hypoganglionic bowel. Conclusion: The SSPT showed shorter hospital days. However, few patients experienced rectal stenosis, but were manageable with botulinum toxin injection. The SSPT requires experienced-pathologist, as well as surgeon, because intra-operation pathology reading is critical for appropriate SSPT. 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引用次数: 1
摘要
目的:单阶段经肛门拉通术(SSPT)治疗先天性巨结肠病已成为最流行的手术方法。本单中心研究比较了单期手术与两期手术治疗新生儿先天性巨结肠病的结果。方法:回顾性分析2003年1月至2014年7月峨山医疗中心所有诊断为巨结肠病并行SSPT或两期手术的患者的病历。结果:SSPT 17例,两期手术28例。SSPT组平均年龄为14.2±7.1 d,两阶段手术组平均造口年龄为15.4±8.6 d, Duhamel手术组平均年龄为188.6±36.3 d。SSPT手术时间短于Duhamel手术(145.0±37.0 min vs. 193.0±36.0 min, p<0.001)。SSPT和两期手术的平均随访时间分别为35.5±34.9个月(范围2-132个月)和56.6±35.5个月(范围1-121个月)。排便问题发生率,如粪便污染或粪便嵌塞,两组间差异无统计学意义(p=0.719)。2例SSPT患者因直肠狭窄需要注射肉毒杆菌毒素。SSPT组3例患者因残留的神经节或下神经节肠再次行直肠内拉通。结论:SSPT的住院天数较短。然而,很少有患者出现直肠狭窄,但注射肉毒杆菌毒素可以控制。SSPT需要有经验的病理学家和外科医生,因为术中病理阅读对合适的SSPT至关重要。SSPT是治疗先天性巨结肠的一种可行、合理的选择。
Single Stage Transanal Endorectal Pull-through Operation for Hirschsprung’s Disease in Neonate: A Single Center Experience
Purpose: The single stage transanal pull-through (SSPT) for Hirschsprung’sdisease is becoming the most popular procedure. This single center study compared the result of single stage operation with two-stage operation for Hirschsprung’s disease in neonates. Methods: We retrospectively reviewed medical records of all patients who were diagnosed as Hirschsprung’s disease and underwent SSPT or two-stage operation operation in Asan Medical Center between January 2003 and July 2014. Results: There were 17 SSPT and 28 two-stage operation. The mean age of SSPT group was 14.2±7.1 days, and the mean age of two-stage operation group was 15.4±8.6 days for stomy formation, and 188.6±36.3 days for Duhamel operation. The operation time of SSPT was shorter than Duhamel operation (145.0±37.0 minutes vs. 193.0±36.0 minutes, p<0.001). The mean follow-up period of SSPT and two-stage operation was 35.5±34.9 months (range, 2-132 months) and 56.6±35.5 months (range, 1-121 months), respectively. Defecation problem rate such as fecal soiling or fecal impaction showed no significant difference between the two groups (p=0.719). Two SSPT patients required botulinum toxin injection due to rectal stenosis. Three patients of SSPT group underwent re-do endorectal pull-through due to remnant aganglionic or hypoganglionic bowel. Conclusion: The SSPT showed shorter hospital days. However, few patients experienced rectal stenosis, but were manageable with botulinum toxin injection. The SSPT requires experienced-pathologist, as well as surgeon, because intra-operation pathology reading is critical for appropriate SSPT. SSPT is a feasible and reasonable option to treat Hirschsprung’s disease.