BACKGROUND: It has been hypothesized that the extensive transanal dissection in transanal endorectal pull-through (TEPT) for Hirschsprung disease (HD) can impair the anal sphincters in neonates and thereby cause incontinence. Theoretically, transabdominal endorectal pull-through might have less impact on the sphincters. The aim of this study was to compare functional outcome in HD patients operated with either TEPT or laparotomy-assisted endorectal pull-through (LEPT) with particular focus on soiling and fecal incontinence. PATIENTS AND METHODS: Anorectal function in 52 children older than 3 years is reported. The patients were operated for HD with either TEPT (n = 28) or LEPT (n = 24) and followed prospectively. Functional outcome was recorded by standardized interviews. The Krickenbeck criteria were used to classify voluntary bowel movements, soiling, and constipation. RESULTS: The median age at follow-up was 5.7 years (3.1-13.2) for TEPT and 10.1 years (7.7-16.2) for LEPT. Twenty-nine patients reported soiling at final follow-up. There was no difference in the rate of soiling between children operated with TEPT (54%) or LEPT (58%). Constipation was reported in 11 children (TEPT, 25%; LEPT, 17%). CONCLUSIONS: The functional outcome and in particular the rate of soiling did not differ between patients operated with LEPT or TEPT. Copyright 2010 Elsevier Inc. All rights reserved.
BACKGROUND: It has been hypothesized that the extensive transanal dissection in transanal endorectal pull-through (TEPT) for Hirschsprung disease (HD) can impair the anal sphincters in neonates and thereby cause incontinence. Theoretically, transabdominal endorectal pull-through might have less impact on the sphincters. The aim of this study was to compare functional outcome in HDpatients operated with either TEPT or laparotomy-assisted endorectal pull-through (LEPT) with particular focus on soiling and fecal incontinence. PATIENTS AND METHODS: Anorectal function in 52 children older than 3 years is reported. The patients were operated for HD with either TEPT (n = 28) or LEPT (n = 24) and followed prospectively. Functional outcome was recorded by standardized interviews. The Krickenbeck criteria were used to classify voluntary bowel movements, soiling, and constipation. RESULTS: The median age at follow-up was 5.7 years (3.1-13.2) for TEPT and 10.1 years (7.7-16.2) for LEPT. Twenty-nine patients reported soiling at final follow-up. There was no difference in the rate of soiling between children operated with TEPT (54%) or LEPT (58%). Constipation was reported in 11 children (TEPT, 25%; LEPT, 17%). CONCLUSIONS: The functional outcome and in particular the rate of soiling did not differ between patients operated with LEPT or TEPT. Copyright 2010 Elsevier Inc. All rights reserved.
Authors: Philipp Romero; Michaela Kroiss; Martin Chmelnik; Ingo Königs; Lucas M Wessel; Stefan Holland-Cunz Journal: Langenbecks Arch Surg Date: 2011-06-22 Impact factor: 3.445
Authors: Olugbenga Michael Aworanti; Dermot Thomas Mcdowell; Ian Michael Martin; Judy Hung; Feargal Quinn Journal: Pediatr Surg Int Date: 2012-09-22 Impact factor: 1.827
Authors: Akemi L Kawaguchi; Yigit S Guner; Stig Sømme; Alexandria C Quesenberry; L Grier Arthur; Juan E Sola; Cynthia D Downard; Rebecca M Rentea; Patricia A Valusek; Caitlin A Smith; Mark B Slidell; Robert L Ricca; Roshni Dasgupta; Elizabeth Renaud; Doug Miniati; Jarod McAteer; Alana L Beres; Julia Grabowski; Shawn D St Peter; Ankush Gosain Journal: J Pediatr Surg Date: 2021-03-28 Impact factor: 2.549