J Korean Assoc Pediatr Surg.  2013 Dec;19(2):130-139. 10.13029/jkaps.2013.19.2.130.

Primary Laparoscopic-Assisted Endorectal Pull-Through for Hirschsprung's Disease

Affiliations
  • 1Department of Surgery, Chungnam National University School of Medicine, Daejeon, Korea. jysul@cnu.ac.kr

Abstract

The application of laparoscopic techniques for the surgical management of Hirschsprung's disease is the recent trend. We described the surgical technique and postoperative long-term outcomes of the one-stage, laparoscopic-assiseted endorectal pull-through operation for Hirschsprung's disease. The technique uses three to four small abdominal ports. Laparoscopic mobilization of the sigmoid colon and rectum is performed and marginal artery-preserving colon pedicle is prepared. The rectal mobilization is performed using a transanal endorectal sleeve technique. The anastomosis is performed 0.5~1 cm above the dentate line. The age at surgery ranged from 6 days to 4 years. The average operative time was 144 minutes. Almost all of the patients passed stool and flatus within 36 hours of surgery. The average hospital stay after surgery was 6.5 days. Among 42 patients, 32 patients older than 3 years old were evaluated for function on defecation. All 32 patients have been continent, of those who needed laxatives were 11 (34.3%) due to constipation and overflow incontinence. Four children (12.5%) have remained dependent on laxatives. Laparoscopic-assisted endorectal pull-through operation for Hirschsprung's disease appears to be safe, provides the less pain, shorter time to full feeding, shorter hospital stay, and excellent cosmetic outcomes. Helping patients and parents ensure the quality of life, they should be provided with counseling, education, and longer-term follow-up care.

Keyword

Hirschsprung's disease; One-stage; Laparoscopic-assisted endorectal pull-through; LAERPT

MeSH Terms

Child
Colon
Colon, Sigmoid
Constipation
Counseling
Defecation
Education
Flatulence
Follow-Up Studies
Hirschsprung Disease*
Humans
Laxatives
Length of Stay
Operative Time
Parents
Quality of Life
Rectum
Laxatives

Cited by  1 articles

Single Stage Transanal Endorectal Pull-through Operation for Hirschsprung’s Disease in Neonate: A Single Center Experience
Ju Yeon Lee, Jung Hyun Choi, Jung-Man Namgung, Dae Yeon Kim, Sung-Cheol Kim
J Korean Assoc Pediatr Surg. 2016;22(2):38-41.    doi: 10.13029/jkaps.2016.22.2.38.


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