Comparative study between one-stage total transanal endorectal pull-through and assisted transanal Soave for treatment of rectosigmoid Hirschsprung’s disease

Purpose
The aim of this study was to compare one-stage total transanal endorectal pull-through (TEPT) and assisted transanal Soave (either by minilaparotomy or by laparoscopy) for treatment of rectosigmoid Hirschsprung’s disease.
Patients and methods
This study was conducted on 40 pediatric patients with rectosigmoid Hirschsprung’s disease. The patients were divided into two groups: group A, consisting of 20 cases that underwent one-stage total TEPT, and group B, consisting of 20 cases that underwent assisted transanal Soave [10 cases underwent minilaparotomy (B) and 10 cases underwent laparoscopy (B)].
Results
The mean age of the patients was 20.01 months in group A and 17.14 months in group B. The male to female ratio was 3 : 1. values less than 0.001 were considered highly significant. The mean operative time in group A was 102 min, whereas that in group B was 117 min. The mean onset time of oral feeding in group A was 1.7±0.86 days and that in group B was 2.25±0.97 days. The mean postoperative hospital stay in group A was 4.2±1.73 days and that in group B was 5±1.87 days. As regards the postoperative complications, they were more common in group B than in group A, and more common in subgroup B than in subgroup B.
Conclusion
TEPT is characterized by a shorter operating time, less bleeding, shorter hospital stay, less morbidity, and earlier recovery compared with similar open pull-through procedures.