Add like
Add dislike
Add to saved papers

Why Do the Patients with Hirschsprung Disease Get Redo Pull-Through Operation?

INTRODUCTION:  The treatment of Hirschsprung disease (HD) is pull-through (PT) surgery. Redo PT can be performed in 1 to 10% of patients after initial PT. In this study, we reviewed the causes and associated factors of redo PT.

MATERIALS AND METHODS:  We retrospectively reviewed medical charts of 657 patients with HD who underwent surgeries between September 1979 and January 2016. The indications for redo PT are as follows. First, there were persistent obstructive symptoms after the first operation, (1) with transition zone shown definitely on contrast study, (2) with anatomic problems, and (3) obstructive symptoms persist despite conservative or nonredo surgical treatment without (1) and (2). We analyzed the causes and associated factors of redo PT.

RESULTS:  A total of 49 (7.5%) patients underwent redo PT. Among them, 41 and 8 patients underwent PT twice and three times, respectively. Among 57 cases of redo, the causes of redo included pathologic problem ( n  = 28)-aganglionosis ( n  = 20), hypoganglionosis ( n  = 4), immature ganglion cell ( n  = 4)-or anatomic problem ( n  = 21)-stricture ( n  = 13), fistula and/or abscess ( n  = 8) at anastomosis. Comparing associated factors between the nonredo and redo groups, the redo group had longer initial PT operation time ( p  = 0.001), more postoperative complications ( p  < 0.001), and more transanal endorectal PT (TERPT) approach as initial PTs ( p  < 0.001). According to causes of redo, the anatomic problem group underwent more third PTs than the pathologic problem group ( p  = 0.010).

CONCLUSION:  Approximately 7.5% of patients experienced redo PT. The cause of redo included pathologic ( n  = 28) or anatomic problem ( n  = 21). Longer operation time, more complications, and TERPT were associated with redo. The anatomic problem group underwent more third PTs than the pathologic problem group.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

Related Resources

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app