Shabbir Hussain, Aqsa Mazhar, Asma Siddiqui.
Transanal endorectal pull-through: an effective alternative to staged management of Hirschsprung’s disease.
Pak J Surg Jan ;29(3):179-82.

Objective: Hirschsprung’s disease, characterized by congenital mega-colon due to absence of ganglion cells in enteric nervous system. Various procedures are described, usually involves staged anatomical correction. Recentaly single stage procedure is advocated. We therefore aim to study outcome of single stage endo-rectal pull through in our setup. Study design: Descriptive case series. Duration and place of study: Between January 2007 to December 2010. Department of Paediatric Surgery, Liaquat National Hospital and Medical College and Habib Medical Centre, Karachi, Pakistan. Patients & methods: All the patients who presented at the department during the study period with the diagnosis of HD were included in the study. Patient records and fi les were assessed .Results of single stage procedure and compared it with staged procedure done during same period for multiple reasons. Quality parameters looked at included perioperative complications , duration of procedure , need for analgesia and medium term functional results . Results: Th ere were total n=42 patients. Male were n=32 and n=10 were females. Single stage TERP was performed in n=22 patients ,while primary colostomy and staged transabdominal pull through is done in n=20 patients. We found single stage procedure without any complication with less operative time and need for analgesia . Other parameters in both types of procedures were comparable. Conclusion: We conclude that single stage transanal endorectal pull through in infants and neonates is safe and it avoids colostomy and multiple procedures and should be procedure of choice in appropriate patients.

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