Soave procedure for infants with Hirschsprung's disease

A. Chattopadhyay Vijaykumar, Rishavdeb Patra, Mohan Murulaiah

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective : Traditionally the surgical treatment of Hirschsprung's disease (H.D) includes preliminary colostomy in normally innervated bowel followed by one of several pull through procedures. The transanal single stage Soave procedure eliminated the need for preliminary colostomy and intraabdominal dissection. It is a recent concept in the management of this disease, and this is the first experience to be reported from India. Methods : Four children aged 3 weeks to one year underwent transanal pull through procedure over a two month period. A rectal mucosectomy was performed starting 0.5 cm. proximal to the dentate line and extending proximally to the level of intraperitoneal rectum. The muscular sleeve was divided circumferentially to allow the full thickness mobilization of the proximal colon. Ganglion cells were confirmed by frozen section and bowel was transected. The rectal muscular cuff was divided longitudinally and the anastomosis was completed. Results: Operative time including the frozen section averaged 160 minutes and average length of the bowel resected was 22 cm. There were no postoperative complications and all patients were discharged on seventh postoperative day. Median follow-up was 5 months (4-6 months) and stool output ranged from 2-4 per day. Conclusion : The authors conclude that a single stage transanal Soave's pull through for Hirschsprung's Disease can be performed successfully in infants. When compared to conventional pull through procedure, it has the potential advantage of lower cost, less risk of damage to pelvic structures, absence of any abdominal incision, a lower incidence of intraperitoneal bleeding and adhesion formation. The preliminary functional results suggest that the patients gain early bowel function post operatively without soiling or constipation. [Indian J Pediatr 2002; 69 (7) : 571-572].

Original languageEnglish
Pages (from-to)571-572
Number of pages2
JournalIndian Journal of Pediatrics
Volume69
Issue number7
DOIs
Publication statusPublished - 01-01-2002

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Hirschsprung Disease
Colostomy
Frozen Sections
Constipation
Operative Time
Disease Management
Rectum
Ganglia
Dissection
India
Colon
Hemorrhage
Costs and Cost Analysis
Incidence

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Vijaykumar, A. Chattopadhyay ; Patra, Rishavdeb ; Murulaiah, Mohan. / Soave procedure for infants with Hirschsprung's disease. In: Indian Journal of Pediatrics. 2002 ; Vol. 69, No. 7. pp. 571-572.
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Soave procedure for infants with Hirschsprung's disease. / Vijaykumar, A. Chattopadhyay; Patra, Rishavdeb; Murulaiah, Mohan.

In: Indian Journal of Pediatrics, Vol. 69, No. 7, 01.01.2002, p. 571-572.

Research output: Contribution to journalArticle

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AB - Objective : Traditionally the surgical treatment of Hirschsprung's disease (H.D) includes preliminary colostomy in normally innervated bowel followed by one of several pull through procedures. The transanal single stage Soave procedure eliminated the need for preliminary colostomy and intraabdominal dissection. It is a recent concept in the management of this disease, and this is the first experience to be reported from India. Methods : Four children aged 3 weeks to one year underwent transanal pull through procedure over a two month period. A rectal mucosectomy was performed starting 0.5 cm. proximal to the dentate line and extending proximally to the level of intraperitoneal rectum. The muscular sleeve was divided circumferentially to allow the full thickness mobilization of the proximal colon. Ganglion cells were confirmed by frozen section and bowel was transected. The rectal muscular cuff was divided longitudinally and the anastomosis was completed. Results: Operative time including the frozen section averaged 160 minutes and average length of the bowel resected was 22 cm. There were no postoperative complications and all patients were discharged on seventh postoperative day. Median follow-up was 5 months (4-6 months) and stool output ranged from 2-4 per day. Conclusion : The authors conclude that a single stage transanal Soave's pull through for Hirschsprung's Disease can be performed successfully in infants. When compared to conventional pull through procedure, it has the potential advantage of lower cost, less risk of damage to pelvic structures, absence of any abdominal incision, a lower incidence of intraperitoneal bleeding and adhesion formation. The preliminary functional results suggest that the patients gain early bowel function post operatively without soiling or constipation. [Indian J Pediatr 2002; 69 (7) : 571-572].

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