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Retrospective analysis of laparoscopically managed pediatric patients with Hirschsprung disease

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Abstract

Purpose

Hirschsprung disease is characterized by aganglionic bowel segment and our goal is to resect it and pull down the normoganglionic bowel. The described techniques such as Swenson, Duhamel, and Soave have seen modification recently through the advent of laparoscopy. Our purpose is to assess the outcome of laparoscopy for management of patients with Hirschsprung disease.

Methods

Twenty eight patients who underwent laparoscopic assisted pull through for Hirschsprung disease were included. Parameters studied included age at surgery, gender, type of pull through, location of transition zone, duration of surgery, post-operative complications, length of hospital stay (LoHS), and complications faced on follow up.

Results

Twenty-eight patients who underwent laparoscopy-assisted pull through were included in this study. Median age at presentation was 24 months of age. 26 patients underwent Swenson, 1 underwent Soave, and 1 underwent Duhamel procedure. None required conversion to open. Three patients successfully underwent primary pull through (Swenson). Median duration of surgery was 4 h. Median LoHS was 6 days. Three patients faced complications during period of hospital stay. Every patient was followed up 3 weeks post-operatively and started on regular Hegar dilator program. Median follow up duration was 24 months. One patient developed enterocolitis, 2 developed constipation, and 1 had night time soiling on follow up. The patient with soiling demonstrated complete resolution of symptoms following bowel management for 3–4 months.

Conclusion

Laparoscopic assisted pull through is a safe and feasible option in pediatric patients with a considerably low risk of complications.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Pediatric Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342008, India

    Revathy Menon, Rahul Saxena, Arvind Sinha, Shubhalaxmi Nayak, Avinash Jadhav, Kirtikumar Rathod & Manish Pathak

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  1. Revathy Menon
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  2. Rahul Saxena
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  3. Arvind Sinha
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Correspondence to Manish Pathak.

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Menon, R., Saxena, R., Sinha, A. et al. Retrospective analysis of laparoscopically managed pediatric patients with Hirschsprung disease. J Ped Endosc Surg 4, 149–155 (2022). https://doi.org/10.1007/s42804-022-00151-y

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  • DOI: https://doi.org/10.1007/s42804-022-00151-y

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