Abstract

Background: Single‑stage transanal pull‑through, supplemented with laparoscopic mobilisation when the aganglionic segment is high or long, has replaced multi‑stage surgery for Hirschsprung’s disease (HD) in many centres. We assessed peri‑operative outcomes and early follow‑up results of this approach in a Vietnamese tertiary hospital.

Methods: In a prospective descriptive study, 145 infants and children with pathologically confirmed HD underwent single‑stage surgery at Hue Central Hospital between January 2020 and December 2023. Demographic data, operative variables, postoperative complications and follow‑up findings were recorded and analysed with IBM SPSS 26.0; results are presented as mean ± SD or frequency (percentage).

Results: The cohort comprised 101 boys and 44 girls; mean age at surgery was 7.3 ± 2.2 months. Constipation (72.4 %), abdominal distension (80 %) and an explosive rectal discharge (“blast sign”, 41.3 %) were predominant clinical features. Mean operative time was 111.2 ± 14.5 minutes; the resected bowel averaged 18.3 ± 7.9 cm. Aganglionosis involved the rectum in 35 patients (24.1 %), sigmoid colon in 65 (44.8 %) and descending colon in 45 (31.0 %). Mean postoperative stay was 5.2 ± 3.5 days. Early complications were infrequent: enterocolitis 12 cases (8.3 %), constipation 3 (2.1 %), perianal dermatitis 2 (1.4 %) and wound infection 1 (0.7 %). After a mean follow‑up of 18.3 ± 2.4 months, all episodes of enterocolitis responded to medical therapy and no anastomotic leaks or recurrent constipation were recorded.

Conclusions: Single‑stage transanal pull‑through, with laparoscopic assistance when indicated, is a safe and effective treatment for Hirschsprung’s disease, yielding short hospitalisation and a low complication profile in this series.