Abstract

Objective: In this study, we compared the results of transanal endorectal pull-through (TEP) and laparoscopic assisted transanal endorectal pull-through technique (LATEP) for Hirschsprung’s disease (HD).

Methods: Forty-seven Hirschsprung’s disease patients, operated on by endorectal pull-through, were divided in two groups according to operation technique and results were compared with each other. In group I, there were 25 patients (17 boys, 8 girls), ages ranged from 12 days to 40 days (average of 24 days) and these patients were treated with TEP between April 2000 and April 2005. In group II, there were 22 patients (15 boys, 7 girls), ages ranged from 10 days to 60 days (average of 32 days) and these patients were treated with LATEP between May 2005 and January 2009. Age, sex, operating time, amount of blood transfusion, hospitalization time, number of daily spontaneous stooling in early and late periods, perianal excoriation, anal dilatations and faecal continence were analyzed. Statistical analysis was made by using the Shapiro-Wilk test, MannWhitney-U test and Chi-Square test. The differences were considered significant when p values were less than 0.05.

Results: In both groups age and sex of the patients were not statistically different. Operating time and amount of blood transfusion was less in group II. Also hospitalization time and number of daily spontaneous stooling in early and late periods was not different between two groups. There was no intestinal obstruction secondary to adhesions in two groups. Perianal excoriation rates were not different between two groups and number of anal dilatations were less in group II significantly (p<0.05). Good results for faecal continence were obtained in the two groups.

Conclusion: Although the functional results are similar in the both groups, we identified that LATEP has some advantages to TEP, such as; minimized blood loss and operating time and less anal dilatations. According to this results we think that LATEP is preferable to TEP for management of HD, when possible.