Abstract

Aim: To present the first transanal endorectal pull-through (TERPT) experiences of our clinic.

Material and Methods: Surgical records of 16 patients with Hirschsprung’s disease (Hd) which had been treated using TERPT technique between 2014 and 2015 were evaluated retrospectively.

Results: Of the sixteen patients, 14 (87.5 %) were male, 2 were (12.5%) female. An average of 15 cm (8-38 cm) intestine was removed. 6 (37.5 %) patients had an enterostomy before definitive operation. All patients were treated with TERTP procedure on average 11 months (2-35 months) of age. We began with lapatoromy with fear of intraabdominal adhesions in 3 of the 6 patients with enterostomy, and suspect of long segment disease in one patient without enterostomy, In another 3 patients we needed to add alaparatomy because of insufficient mobilization via transanal route. One patient was operated for abdominal wound dehiscence repair in postoperative 6^th day, and, one patient was lost in the early postoperative hours with an unknown cause, maybe due to an embolus originated from excessive tension in colonic vessels. The average length of hospital stay was 6 days (4-12 days).

The average postoperative follow up period was 14 months (1-21 months) in the remaining 15 patients. In 3 of them transient anastomotic dilatation was performed for mild anastomotic stenosis, while 10 patients had mild-to-severe perineal dermatitis but responded well to topical medications. Daily defecation frequencies were between 8-10 in the first three postoperative months,but decreased to 1-3/day in the follw up. Our patients who have recovered with the required care treatments are now uneventful and their follow-up is continuing.

Conclusion: In our 30-year-old clinic, Rehbein operation was the preferred procedure for the patients with Hd. After our limited experience with TERPT technique, we think that this procedure, especially when performed as a single operation without enterostomy, provides surgeon and family satisfaction.