The outcomes of transanal endorectal pull-through for Hirschsprung's disease according to the mucosectomy-commencing points: A study based on the results of a nationwide survey in Japan.
Adolescent
Adult
Child
Child, Preschool
Digestive System Surgical Procedures
/ adverse effects
Enterocolitis
/ etiology
Fecal Incontinence
/ etiology
Hirschsprung Disease
/ surgery
Humans
Infant
Infant, Newborn
Intestinal Mucosa
/ surgery
Japan
Middle Aged
Postoperative Complications
/ etiology
Rectal Prolapse
/ etiology
Retrospective Studies
Surveys and Questionnaires
Young Adult
Hirschsprung’s disease
Mucosectomy-commencing point
Nationwide survey
Outcome
Rectal mucosal prolapse
TAEPT
Journal
Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
18
08
2019
accepted:
24
08
2019
pubmed:
16
11
2019
medline:
26
3
2020
entrez:
16
11
2019
Statut:
ppublish
Résumé
Although the mucosectomy-commencing points on transanal endorectal pull-through (TAEPT) differ among reports, the optimal point is unclear. This study assessed the outcomes among different mucosectomy-commencing points. We conducted a nationwide survey from 2008 to 2012. The data of 1,087 Hirschsprung's disease patients were collected, and data on those who underwent TAEPT were extracted. The patients were divided according to the mucosectomy-commencing points into two groups: in Group A, mucosectomy was started ≥5 mm from the dentate line (DL), and in Group B, mucosectomy was started <5 mm from the DL. The extent of the aganglionic segment and postoperative complications in the month after TAEPT were compared. The data of 327 patients were extracted (Group A, n=155; B, n=172). Aganglionosis extending to the sigmoid colon was the most frequent in both groups. Regarding postoperative complications, the patients of each group experienced enterocolitis (Group A: 8.4%; B: 7.6%) and incontinence (A: 3.9%; B: 2.9%). The incidence of rectal mucosal prolapse was significantly greater in Group B (4.1%); (A: 0%, p=0.02). Although the outcomes of TAEPT were comparable in both groups, rectal mucosal prolapse was significantly frequent in patients in whom the commencing point was <5 mm from the DL. Retrospective study LEVEL OF EVIDENCE: Level III.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
Although the mucosectomy-commencing points on transanal endorectal pull-through (TAEPT) differ among reports, the optimal point is unclear. This study assessed the outcomes among different mucosectomy-commencing points.
METHODS
METHODS
We conducted a nationwide survey from 2008 to 2012. The data of 1,087 Hirschsprung's disease patients were collected, and data on those who underwent TAEPT were extracted. The patients were divided according to the mucosectomy-commencing points into two groups: in Group A, mucosectomy was started ≥5 mm from the dentate line (DL), and in Group B, mucosectomy was started <5 mm from the DL. The extent of the aganglionic segment and postoperative complications in the month after TAEPT were compared.
RESULTS
RESULTS
The data of 327 patients were extracted (Group A, n=155; B, n=172). Aganglionosis extending to the sigmoid colon was the most frequent in both groups. Regarding postoperative complications, the patients of each group experienced enterocolitis (Group A: 8.4%; B: 7.6%) and incontinence (A: 3.9%; B: 2.9%). The incidence of rectal mucosal prolapse was significantly greater in Group B (4.1%); (A: 0%, p=0.02).
CONCLUSIONS
CONCLUSIONS
Although the outcomes of TAEPT were comparable in both groups, rectal mucosal prolapse was significantly frequent in patients in whom the commencing point was <5 mm from the DL.
TYPE OF STUDY
METHODS
Retrospective study LEVEL OF EVIDENCE: Level III.
Identifiants
pubmed: 31727384
pii: S0022-3468(19)30575-5
doi: 10.1016/j.jpedsurg.2019.08.035
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2546-2549Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.