COMPARATIVE CHARACTERISTICS OF OUTCOMES AFTER SURGICAL TREATMENT OF THE HIRSCHPRUNG’S SHORT FORM DISEASE IN CHILDREN


Cite item

Full Text

Abstract

Actuality. The Hirschsprung’s disease is one of the leading pathologies in the digestive tract in children. Despite the variety of diagnostic techniques for this disease, none of them has an absolute certainty when the short form disease is suspected, and only the assessment of findings after complex examination plus clinical picture can result in establishing a reliable diagnosis. The authors analyze outcomes of surgical treatment of the Hirschspring’s short form disease in children when the technique of dosed dissection of the internal anal sphincter under ultrasound control was applied and compare these results with those when conventional surgical techniques were used. Material and methods. 83 children aged 1-17.5 y.o. with the established diagnosis of Hirschsprung’s disease and an ultrashort aganglionic segment were taken into the study. Patients were divided into two groups. Group 1 (41 patient) who had surgical correction by the Lynn technique; Group 2 ( 42 children) who were operated on by the new developed technique. Results. 74% (31 patient) of children who were operated on by the dosed dissection of the internal anal sphincter under ultrasound control had good results in their late postoperative period; 10 patients (24%) had satisfactory results; unsatisfactory outcome was seen in 1 patient (2%). In children , who were operated on by the Lynn technique, good results were in 23 patients (57%); satisfactory results in 15 patients (37%) and unsatisfactory result in 3 patients (6%). Conclusion. The rectal form of Hirschsprung’s disease with a short and ultrashort segment requires surgical treatment in the vast majority of cases. In this case, surgery with dosed dissection of the internal anal sphincter under ultrasound control can be a method of choice.

About the authors

R. I. Abaikhanov

National Medical Research Center of Children’s Health, Ministry of Health of Russian Federation

Author for correspondence.
Email: r09r@mail.ru
ORCID iD: 0000-0003-1803-6987
Russian Federation

T. A. Prudnikova

National Medical Research Center of Children’s Health, Ministry of Health of Russian Federation

Email: noemail@neicon.ru
ORCID iD: 0000-0002-9969-1993
Russian Federation

I. V. Kirgizov

Central Clinical Hospital with Outpatient Unit, Department of Presidential Affairs

Email: noemail@neicon.ru
ORCID iD: 0000-0001-5796-5266
Russian Federation

References

  1. Ленюшкин А.И. Болезнь Гиршпрунга: традиции и новые тенденции (30 летний клинический опыт). Детская хирургия. 1997; (1): 31-7.
  2. Полухов Р.Ш. Непосредственные результаты трансанального эндоректального низведения при болезни Гиршпрунга у детей. В кн.: Актуальные проблемы педиатрии: матер. ХVIII конгр. пед. России. Москва: 2015.
  3. Смирнов А.Н., Дронов А.Ф. , Холостова В.В., Маннанов А.Г., Залихин Д.В., Ермоленко Е.Ю. Повторные операции при болезни Гиршпрунга у детей. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2013; 3(4): 42-9.
  4. Комиссаров И.А., Леванович В.В., Комиссаров М.И. Использование рассечения внутреннего сфинктера заднего прохода при его гипертрофии у детей. Вестник хирургии им. И.И. Грекова. 2010; 169(4): 58-60.
  5. Doodnath R., Puri P. Long-term outcome of internal spchincter myectomy in patients with internal anal sphincter achalasia. Pediatr. Surg. Int. 2009, Oct; 25(10): 869-71. doi: 10.1007/s00383-009-2436-5
  6. Bradnock T.J., Knight M., Kenny S., Nair M., Walker G.M. Hirschsprung’s disease in the UK and Ireland: incidence and anomalies. Archives of Disease in Childhood. 2017 Aug; 102(8): 722-727. doi: 10.1136/archdischild-2016-311872
  7. Tran V.Q., Mahler T., Bontems P., Truong D.Q., Robert A., Goyens P., Steyaert H. Interest of Anorectal Manometry During Long-term Follow-up of Patients Operated on for Hirschsprung’s Disease. Journal of Neurogastroenterology and Motility. 2018; 24(1): 70-8. https://doi.org/10.5056/jnm17019
  8. Hong J. Clinical Applications of Gastrointestinal Manometry in Children. Pediatric Gastroenterology, Hepatology & Nutrition. 2014 Mar; 17(1): 23-30. https://doi.org/10.5223/pghn.2014.17.1.23
  9. Guinard-Samuel V., Bonnard A., Penchmaur M., Berrebi D. A variant pattern of Calretinin immunogistochemistry on rectal suction- biopsies is fulli specific of short- segment Hirschsprung`s disease. Pediatr. Surg. Int. 2014 Aug; 30(8): 803-8. doi: 10.1007/s00383-014-3526-6. Epub 2014 Jun 20.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2019

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies