Abstract:

Objectives: We compared the results of patients who underwent transanal endorectal pull-through (TEPT) and Martin-modified Duhamel operations for Hirschsprung's disease (HD). Materials and Methods: Between 2002 and 2007, we evaluated 53 patients with HD treated with TEPT (Group 1, n=24), endorectal pull-through with a laparotomy requirement after an initiated transanal approach (Group 2, n=12) and Martin-modified Duhamel (Group 3, n=17). Age, gender, length of aganglionic segment, intraoperative details, postoperative early complications and long-term functional outcomes are evaluated and compared among these patient groups. Results: In this study age at the time of the operation, duration of the operation, time to first oral feeding, time to first stool and hospital stay in the patients of group 1 were significantly less or shorter than those in group 2 and group 3 (p<0.001). The blood transfusion requirement during operation in group 1 was less than the other groups, but this difference didn't reach statistical significance (p>0.05). Postoperative enterocolitis had a higher incidence in group 3, but there was also no significant difference (p>0.05). There was no difference in the long-term functional results (continence, fecal soiling, constipation) of all three procedures (p>0.05). Conclusion: TEPT is both a feasible and safe technique. It may be the first choice in patients with early diagnosed rectosigmoid HD patients without enterocolitis or bowel dilatation.

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