Features of postoperative course in children with Hirschsprung disease after endorectal interventions



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Introduction. Minimally invasive procedures used in the treatment of children with Hirschsprung’s disease (HD) have reduced the rate of complications and allowed to perform these surgeries at any age. In literature, one can find much information on surgical treatment, complications, long-term results. However, features of postoperative period and mechanisms of colon function restorations after different pull-through procedures are not well described.
Material and methods. From 2008 to 2019, 77 patients with different forms of HD were operated in Children’s Clinical Specialized Center of High Medical Technologies in St-Petersburg. Patients were aged from 14 days till 3 years. They were divided into 3 groups according to the applied endorectal technique- Soave, «Soavson», Swenson. The following parameters were analyzed: age, sex, stoma, surgery duration, length of hospitalization, features of postoperative period, complications.
Results. An early postoperative period was similar in all groups. Two children after Soave procedure (9%) had wound infection; two children had anastomotic stricture (1 – Soave, 1 - «Soavson») which was treated with regular dilatations. Enterocolitis was diagnosed in 19 patients (25%). 20 patients (26%) had no self-defecation for 14 days – 6 months after the surgery. Most of the patients had HD of the rectosigmoid form. These disorders developed more often in patients after Soave and «Soavson» procedures, less often- after Svenson one.
Discussion. An issue of choosing an optimal technique for rectal dissection is still a debatable one. There has been no any significant difference revealed between the three variants of endorectal dissection during an early postoperative period.
Conclusion. A transanal endorectal pull-through procedure in children with HD is a preferable option of choice. It gives good functional outcomes. Features of the postoperative period are caused by the adaptation of new intestine to new defecation conditions.

作者简介

T. Kesaeva

Children’s City Multidisciplinary Clinical Specialized Center of High Medical Technologies; Pavlov First Saint Petersburg State Medical University

编辑信件的主要联系方式.
Email: tomo4ka13@mail.ru
ORCID iD: 0000-0003-4116-5832

Tamara V. Kesaeva, pediatric surgeon

St-Petersburg, 198205

St-Petersburg, 197022

俄罗斯联邦

S. Karavaeva

Pavlov First Saint Petersburg State Medical University; Federal State Budgetary Educational Institution of Higher Education «North-Western State Medical University Named after I.I. Mechnikov

Email: fake@neicon.ru
ORCID iD: 0000-0001-5884-9128

St-Petersburg, 197022

St-Petersburg, 197022

俄罗斯联邦

A. Kotin

Pavlov First Saint Petersburg State Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0003-1207-7171

St-Petersburg, 197022

俄罗斯联邦

A. Kagan

Children’s City Multidisciplinary Clinical Specialized Center of High Medical Technologies; Pavlov First Saint Petersburg State Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0002-8657-4886

St-Petersburg, 198205

St-Petersburg, 197022

俄罗斯联邦

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