Comparison between pure transanal soave and laparoscopic assisted techniques in treatment of children with Hirschsprung disease

Emad, Yehia; Bersy, Mohamed Ali; Eldebeiky, Mohamed Soliman; Ghanem, Wael Ahmed Radwan; Allam, Ayman Mostafa

doi:10.4103/ejs.ejs_40_23

Comparison between pure transanal soave and laparoscopic assisted techniques in treatment of children with Hirschsprung disease

Authors

Abstract

Background
Several operative techniques have been developed for the treatment of Hirschsprung's disease in the past decades. One-stage trans-anal pull-through was first performed in 1998.
Objectives
To evaluate early postoperative complications after laparoscopic assisted and pure trans-anal Soave for recto-sigmoid Hirschsprung's disease.
Patients and methods
This prospective study was performed on 20 pediatric patients with Hirschsprung's disease from January 2021 to January 2023 at Ainshams university hospitals. The patients were divided into two equal groups: group (A) underwent pure transanal trans-anal Soave, and group (B) underwent laparoscopic assisted trans-anal soave. Demographic, clinical data, preoperative investigations, operative records, postoperative outcome were studied.
Results
After one year of follow up staining/soiling in group A was present in 2(occasional staining); while group B, staining/soiling was present in 2(occasional staining). There was no statistically significant difference between the two group's early post-operative follow up as regard, anastomotic leakage, anastomotic stricture and intestinal obstruction, enterocolitis, buttock excoriation and morbidity leading to colostomy. However, there was a statistically significant difference regarding duration of the whole operation being longer in the lap group (160–210 min) compared to (95–140 min) in the pure trans anal group. While on the other hand, there was no significant statistical difference regarding the anal stretch timing in both groups as 122.5 min in pure trans-anal group while it was 100 min in laparoscopic assisted trans-anal group.
Conclusion
Laparoscopically assisted trans-anal soave was less invasive but has the same clinical outcome compared with trans-anal Soave as regard stooling function and postoperative follow up.

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