Open versus transanal pull-through for Hirschsprung disease: a systematic review of long-term outcome.
نویسندگان
چکیده
INTRODUCTION Various surgical techniques for the treatment of Hirschsprung disease (HD) have been proposed. The most relevant long-term complications of HD surgery include constipation, soiling/incontinence, enterocolitis, and anastomotic stricture. To date, there has been no randomized controlled trial evaluating the long-term outcome of OPEN surgery compared with transanal approaches with and without laparoscopy (laparoscopic-assisted transanal-endorectal pull-through [L-TERPT] and transanal-endorectal pull-through [TERPT]). We performed a systematic literature review of the long-term outcome of OPEN surgery compared with L-TERPT/TERPT. METHODS Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. With the cumulative data, a comparative meta-analysis was performed for the outcome parameters "constipation," "soiling/incontinence," "enterocolitis," and "anastomotic stricture." RESULTS Functional outcome of surgical techniques for HD was highly variable. We could show a significant advantage of L-TERPT/TERPT over OPEN surgery regarding the incidence of soiling/incontinence and constipation. No differences were seen for enterocolitis and anastomotic stricture. CONCLUSION Significant differences in the long-term outcome of OPEN surgery compared with L-TERPT/TERPT were identified in this review. We conclude from our data that L-TERPT/TERPT represents a valid option in the treatment of HD and might have some advantages over the OPEN techniques. However, the present data should be interpreted carefully due to limitations in the quality of the study design in most reports. Prospective, randomized, multicenter trials are urgently needed to overcome this weakness of the current literature.
منابع مشابه
Laparoscopic assistance for primary transanal pull-through in Hirschsprung's disease: a systematic review and meta-analysis
OBJECTIVE To compare outcomes following totally transanal endorectal pull-through (TTERPT) versus pull-through with any form of laparoscopic assistance (LAPT) for infants with uncomplicated Hirschsprung's disease. DESIGN Systematic review and meta-analysis. SETTING Five hospitals with a paediatric surgical service. PARTICIPANTS 405 infants with uncomplicated Hirschsprung's disease. INTE...
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PURPOSE Transanal endorectal pull-through has changed the treatment of Hirschsprung's disease (HD) in the past decade. The aim of the study was to compare outcomes, obtained in a single center, with laparotomic Duhamel (LTD), laparoscopic Duhamel (LSD), and laparoscopic-assisted transanal endorectal pull-through (LTEPT). MATERIALS AND METHODS We retrospectively reviewed the charts of all pati...
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متن کاملDevelopment of Frequency of Stools over Time in Children with Hirschsprung Disease Posttransanal Endorectal One-Stage Pull-through.
BACKGROUND The transanal endorectal one-stage pull-through (TERPT) procedure in children with Hirschsprung disease (HD) is frequently used worldwide. To give the children's families realistic expectations and to plan the medical care for the period after TERPT, the outcome is of great importance. AIM The aim of this article is to collect information on the number of stools passed daily after ...
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عنوان ژورنال:
- European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie
دوره 23 2 شماره
صفحات -
تاریخ انتشار 2013