Clinical outcome of transanal endorectal pull-through for neonatal hirschsprung's disease

Objective To analyze the diagnosis and treatment of neonatal Hirschsprung's disease (HD)and to evaluate the outcome of one-stage transanal endorectal pull-through in the treatment of neonatal HD.Methods The records of 48 newborns with HD from July 2004 to July 2013 were reviewed retrospectively.Base data,details of management,complications,and outcomes were examined.Results Totally 48 consecutive newborns with HD were identified,of which 32 were classical type,9 were long-segment type and 7 were short-segment type.All were successfully treated by one-stage transanal endorectal pull-through procedure,of which 39 were transanal only,7 were laparoscopic assisted,2 were open.The average preoperative preparation time was (7 ± 2) d.The operation time was (88 ± 15) min.The average intra-operative blood loss was (7 ± 2) ml.The average length of resected bowel was (18 ± 6) cm.The mean hospital stay was (10± 2) d.The follow-up period for all patients was in the range of 3 months to 8 years,and all grew well.Complications included anastomotic stricture (9 cases),constipation (8 cases),incontinence (8 cases),enterocolitis (10 cases),et al.All of them got better at last after treatment.Barium enema showed that the shape of colon had become normal.The score of bowel movement assessment was 4 for 38 cases,3 for 7 cases and 2 for 1 case.Conclusion It is suggested that one-stage transanal endorectal pull-through procedure for neonatal HD was safe,for its less complication good outcome and long term effect,which is worthy of further promotion. Key words: Neonatal Hirschsprung's disease;  Operation;  Treatment