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Literature Review of the Frequency of Reoperations after One Stage Transanal Endorectal Pull-Through Procedure for Hirschsprung’s Disease in Children

Lopera, Carlos; Stenström, Pernilla LU ; Anderberg, Magnus LU and Arnbjörnsson, Einar LU (2012) In Surgical Science 3. p.290-294
Abstract
Background: Transanal endorectal one-stage pull-through (TERPT) procedure in children with Hirschsprung’s disease (HD) has gained worldwide acceptance. However surgical success is often reported separately, while the necessity for true reoperation is difficult to establish. Aim: To evaluate the incidence of reoperations following TERPT procedure. The findings will be important in counseling and planning childcare for HD patients as well as providing a benchmark for single centers clinical results. Methods: A literature review of reported TERPT operations on children with HD between 1998 through 2011 was performed. Only planned TERPT operation reports were included. Information was collected with particular emphasis on reoperations and... (More)
Background: Transanal endorectal one-stage pull-through (TERPT) procedure in children with Hirschsprung’s disease (HD) has gained worldwide acceptance. However surgical success is often reported separately, while the necessity for true reoperation is difficult to establish. Aim: To evaluate the incidence of reoperations following TERPT procedure. The findings will be important in counseling and planning childcare for HD patients as well as providing a benchmark for single centers clinical results. Methods: A literature review of reported TERPT operations on children with HD between 1998 through 2011 was performed. Only planned TERPT operation reports were included. Information was collected with particular emphasis on reoperations and their reasons. Results: Out of 26 published articles 23 were in-cluded, reporting on 836 children, female/male ratio: 1/3.3, undergoing the TERPT procedure as the only operative in-tervention with described postoperative courses. The children comprised neonates, <4 weeks (38%), babies <1 year (35%), toddlers, 1 - 3 years (15%) and children >3 years of age (12%). The average follow up was 18.5 (6 - 38) months. The resected bowel length mean was 20.5 cm. Forty-one reoperations were reported (4.9%), including 24 laparotomies, 8 laparoscopies, 6 colostomies and ileostomies in 3 children. Only 2 re-do TERPT were reported (0.2%). Seven patients were considered TERPT failures (0.8%) with 5 requiring diverting colostomies and additional transabdominal pull- through operations. Two myectomies were performed (0.2%). One child with aganglionosis underwent a Duhamel pull through. Two (0.2%) had serious damage to the urinary tract also one child with a vas deferens lesion was reoperated. Two bowel obstructions required adhesiolysis. Eight anastomotic dehiscences (0.9%) required surgery after reparation. One prolapse of the pulled through colon was reported. Six patients (0.7%) suffered anastomotic leaks. Anastomotic strictures rate was 2.8%, all repaired with anal dilatation. Conclusion: The review supports the low incidence of re-ported reoperations for the TERPT procedure. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Transanal Endorectal Pull-Through (TERPT), Hirschsprung’s Disease, Postoperative Complications, Stricture, Enterostomy
categories
Higher Education
in
Surgical Science
volume
3
pages
290 - 294
publisher
Scientifc Research
ISSN
2157-9415
DOI
10.4236/ss.2012.36058
language
English
LU publication?
yes
id
f0ca401a-4a21-4c3f-b821-35636031a480 (old id 3738339)
date added to LUP
2016-01-28 10:31:55
date last changed
2017-01-24 10:00:27
@article{f0ca401a-4a21-4c3f-b821-35636031a480,
  abstract     = {Background: Transanal endorectal one-stage pull-through (TERPT) procedure in children with Hirschsprung’s disease (HD) has gained worldwide acceptance. However surgical success is often reported separately, while the necessity for true reoperation is difficult to establish. Aim: To evaluate the incidence of reoperations following TERPT procedure. The findings will be important in counseling and planning childcare for HD patients as well as providing a benchmark for single centers clinical results. Methods: A literature review of reported TERPT operations on children with HD between 1998 through 2011 was performed. Only planned TERPT operation reports were included. Information was collected with particular emphasis on reoperations and their reasons. Results: Out of 26 published articles 23 were in-cluded, reporting on 836 children, female/male ratio: 1/3.3, undergoing the TERPT procedure as the only operative in-tervention with described postoperative courses. The children comprised neonates, &lt;4 weeks (38%), babies &lt;1 year (35%), toddlers, 1 - 3 years (15%) and children &gt;3 years of age (12%). The average follow up was 18.5 (6 - 38) months. The resected bowel length mean was 20.5 cm. Forty-one reoperations were reported (4.9%), including 24 laparotomies, 8 laparoscopies, 6 colostomies and ileostomies in 3 children. Only 2 re-do TERPT were reported (0.2%). Seven patients were considered TERPT failures (0.8%) with 5 requiring diverting colostomies and additional transabdominal pull- through operations. Two myectomies were performed (0.2%). One child with aganglionosis underwent a Duhamel pull through. Two (0.2%) had serious damage to the urinary tract also one child with a vas deferens lesion was reoperated. Two bowel obstructions required adhesiolysis. Eight anastomotic dehiscences (0.9%) required surgery after reparation. One prolapse of the pulled through colon was reported. Six patients (0.7%) suffered anastomotic leaks. Anastomotic strictures rate was 2.8%, all repaired with anal dilatation. Conclusion: The review supports the low incidence of re-ported reoperations for the TERPT procedure.},
  author       = {Lopera, Carlos and Stenström, Pernilla and Anderberg, Magnus and Arnbjörnsson, Einar},
  issn         = {2157-9415},
  keyword      = {Transanal Endorectal Pull-Through (TERPT),Hirschsprung’s Disease,Postoperative Complications,Stricture,Enterostomy},
  language     = {eng},
  pages        = {290--294},
  publisher    = {Scientifc Research},
  series       = {Surgical Science},
  title        = {Literature Review of the Frequency of Reoperations after One Stage Transanal Endorectal Pull-Through Procedure for Hirschsprung’s Disease in Children},
  url          = {http://dx.doi.org/10.4236/ss.2012.36058},
  volume       = {3},
  year         = {2012},
}