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Abstract
Objective: This study aims to determine the cause and evaluating the impact of an assisted abdominal approach in the outcomes of the TOSEPT in children with Hirschsprung’s Disease (HD).
Methods: A retrospective study was conducted at Pediatric and Abdominal Emergency Surgery department of Hue central hospital. All of patients were operated on for HD in our department between January 2012 and June 2020 (excluding cases indicated for primary laparoscopic surgery).
Result: A total of 446 patients diagnosed on for HD with histopathological proof were operated. About 66 (14.79%) patients with HD who required TOSEPT with an additional abdominal approach to complete the operation. About 44 (66,66%) patients were under 12 months old. Two additional abdominal approaches were concluded in the study: open operation (78.79%) and laparoscopic (21.21%). The reason for the
additional approaches were sigmoid colon adherent to lateral abdominal wall (24.24%), pelvic inflammation (18.18%), an extremely dilated colon and rectum (6.06%) or long aganglionic segment (51.51%). Length of the resected colon: 13.30 ± 3.45 cm (open group) and 19.70 ± 4.50 cm (laparoscopic group). Average operative time: 156 ± 12 minutes (open group) and 170 ± 14 minute (laparoscopic group). No deaths or intra-operative complication occurred in the laparoscopic group. Grade II complication based on Dindo - Clavien classfication occurred in 14 (21.21%) of the open group and one (1.51%) grade III complication. The length of hospital stay was shorter in the laparoscopic group at 5 ± 1.5 days compared to 7 ± 2.5 days for the open group. All of the complications were grade I or II, manly enterocolitis at 3 - month follow - up.
Conclusion: TOSEPT is safe and effective for all of short mesocolon, unexpected long ganglionic segment, pelvis inflammation or other cases cannot be operated only transanal. Laparoscopic surgery as the additional abdominal approach should be used to reduce the complications
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| Published | 06-01-2025 | |
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| Issue | No. 76 (2022) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.76.16 | |
| Keywords | Bệnh Hirschsprung, qua đường hậu môn có kết hợp đường bụng Hischsprung’s disease, Transanal one - stage endorectal pull - through, Additional abdominal approach. |
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