Minimally Invasive Techniques for Hirschsprung Disease

Chiara Iacusso, Lorenzo Leonelli, Laura Valfrè, Andrea Conforti, Fabio Fusaro, Barbara Daniela Iacobelli, Patrizia Bozza, Francesco Morini, Girolamo Mattioli, Pietro Bagolan

Research output: Contribution to journalArticle

Abstract

Background: Surgical treatment of Hirschsprung disease (HD) evolved in the last decades with the introduction of new innovative minimally invasive techniques. The aim of present study is to compare the results from two centers, applying similar minimal access approaches, total transanal endorectal pull-through (TEPT) and laparoscopic-assisted transanal pull-through (LA-TAPT). Materials and Methods: Data of all patients admitted between January 2011 and December 2016 in two Italian referral Hospitals for HD were retrospectively collected and analyzed. Exclusion criteria were as follows: redo procedure, patients with total colonic aganglionosis (ileostomy), patients lost at follow-up, or missing data. Patients who underwent TEPT and LA-TAPT were compared for gestational age, birth weight, age and weight at surgery, associated malformation, genetic syndrome, length of hospital stay, and early postoperative complications (within 30 days). Statistical analysis: Fisher's test and Mann-Whitney test; statistical significance set at P < .05. Results: None of the patients who underwent TEPT required laparotomy or laparoscopic assistance. Patients who underwent TEPT had lower age (P = .001), lower body weight (P < .0001), a significant higher rate of associated congenital heart disease (P = .006), and longer postoperative stay. In addition, the prevalence of perianal dermatitis was higher in TEPT patients (17/61 [28%] versus 2/46 [4%], P = .001). The two groups were similar in terms of postoperative enterocolitis, redo surgery, anastomotic stenosis, and other infective complications. Conclusion: Both minimally invasive techniques allow surgical advantages and outcomes; TEPT avoids pneumoperitoneum and the transperitoneal approach, with no need for laparoscopic instrumentation. TEPT group had longer postoperative stay, probably due to the higher prevalence of associated cardiac anomalies, and higher prevalence of perianal dermatitis, probably due to the lower age at operation.

Original languageEnglish
Pages (from-to)1605-1608
Number of pages4
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques - Part A
Volume29
Issue number12
DOIs
Publication statusPublished - Dec 2019

Fingerprint Dive into the research topics of 'Minimally Invasive Techniques for Hirschsprung Disease'. Together they form a unique fingerprint.

  • Cite this

    Iacusso, C., Leonelli, L., Valfrè, L., Conforti, A., Fusaro, F., Iacobelli, B. D., Bozza, P., Morini, F., Mattioli, G., & Bagolan, P. (2019). Minimally Invasive Techniques for Hirschsprung Disease. Journal of Laparoendoscopic and Advanced Surgical Techniques - Part A, 29(12), 1605-1608. https://doi.org/10.1089/lap.2019.0165