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One-stage transanal endorectal pull-through for Hirschsprung disease: experience with 229 neonates

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Abstract

Objective

To evaluate the safety and efficacy of transanal endorectal pull-through (TEPT) and the long-term outcomes in newborns with Hirschsprung disease (HD).

Methods

A total of 229 newborns with HD underwent one-stage TEPT between 2007 and 2020, and the diagnoses were confirmed by rectal biopsy. The perioperative clinical course for all patients was reviewed, and the postoperative short- and long-term outcomes were assessed.

Results

A total of 229 neonates (187 male and 42 female) had a median age at TEPT of 17 days (range 6–28 days). Sixty-eight patients (29.7%) underwent TEPT combined with an abdominal approach or laparoscopy. Early postoperative complications (using the Clavien–Dindo grading system) were documented in 36 patients (15.7%), and late postoperative complications were noted in 9 patients (3.9%). The follow-up period in the remaining 165 children ranged from 1.2 to 14.0 years (median 5.0 years). A total of 106 of the patients older than four years old took part in an interview about bowel function, and 85 patients (80.2%) had bowel function scores (BFS) ≥ 18.

Conclusion

TEPT is effective and safe for HD in the neonatal period and presents with a low rate of complications and an acceptable outcome.

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Author notes

  1. Yanan Zhang and Zhaozhou Liu have contributed equally to this work.

Authors and Affiliations

  1. Department of Neonatal Surgery, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, 56 Nanlishi Road, Beijing, 100045, China

    Yanan Zhang, Zhaozhou Liu, Shuangshuang Li, Shen Yang, Jiawei Zhao, Ting Yang, Siqi Li, Yongwei Chen, Weihong Guo, Dawei Hou, Yingzi Li & Jinshi Huang

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  1. Yanan Zhang
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Contributions

JH, YZ, and ZL designed the study. ZL and YZ wrote the main manuscript text. SY, WG, SL, and YL prepared Tables 1, 2, 3, 4, and 5. All authors reviewed the manuscript.

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Correspondence to Jinshi Huang.

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Zhang, Y., Liu, Z., Li, S. et al. One-stage transanal endorectal pull-through for Hirschsprung disease: experience with 229 neonates. Pediatr Surg Int 38, 1533–1540 (2022). https://doi.org/10.1007/s00383-022-05198-9

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