TY - JOUR
T1 - The outcomes of transanal endorectal pull-through for Hirschsprung's disease according to the mucosectomy-commencing points
T2 - A study based on the results of a nationwide survey in Japan
AU - Obata, Satoshi
AU - Ieiri, Satoshi
AU - Akiyama, Takashi
AU - Urushihara, Naoto
AU - Kawahara, Hisayoshi
AU - Kubota, Masayuki
AU - Kono, Miyuki
AU - Nirasawa, Yuji
AU - Honda, Shohei
AU - Nio, Masaki
AU - Taguchi, Tomoaki
N1 - Funding Information:
This study was supported by a grant from The Ministry of Health, Labour and Welfare of Japan (Health and Labour Sciences Research Grants for Research on Intractive Disease [H26-045]).
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/12
Y1 - 2019/12
N2 - Background/Aim: Although the mucosectomy-commencing points on transanal endorectal pull-through (TAEPT) differ among reports, the optimal point is unclear. This study assessed the outcomes among different mucosectomy-commencing points. Methods: We conducted a nationwide survey from 2008 to 2012. The data of 1,087 Hirschsprung's disease patients were collected, and data on those who underwent TAEPT were extracted. The patients were divided according to the mucosectomy-commencing points into two groups: in Group A, mucosectomy was started ≥ 5 mm from the dentate line (DL), and in Group B, mucosectomy was started < 5 mm from the DL. The extent of the aganglionic segment and postoperative complications in the month after TAEPT were compared. Results: The data of 327 patients were extracted (Group A, n = 155; B, n = 172). Aganglionosis extending to the sigmoid colon was the most frequent in both groups. Regarding postoperative complications, the patients of each group experienced enterocolitis (Group A: 8.4%; B: 7.6%) and incontinence (A: 3.9%; B: 2.9%). The incidence of rectal mucosal prolapse was significantly greater in Group B (4.1%); (A: 0%, p = 0.02). Conclusions: Although the outcomes of TAEPT were comparable in both groups, rectal mucosal prolapse was significantly frequent in patients in whom the commencing point was < 5 mm from the DL. Type of study: Retrospective study Level of evidence: Level III
AB - Background/Aim: Although the mucosectomy-commencing points on transanal endorectal pull-through (TAEPT) differ among reports, the optimal point is unclear. This study assessed the outcomes among different mucosectomy-commencing points. Methods: We conducted a nationwide survey from 2008 to 2012. The data of 1,087 Hirschsprung's disease patients were collected, and data on those who underwent TAEPT were extracted. The patients were divided according to the mucosectomy-commencing points into two groups: in Group A, mucosectomy was started ≥ 5 mm from the dentate line (DL), and in Group B, mucosectomy was started < 5 mm from the DL. The extent of the aganglionic segment and postoperative complications in the month after TAEPT were compared. Results: The data of 327 patients were extracted (Group A, n = 155; B, n = 172). Aganglionosis extending to the sigmoid colon was the most frequent in both groups. Regarding postoperative complications, the patients of each group experienced enterocolitis (Group A: 8.4%; B: 7.6%) and incontinence (A: 3.9%; B: 2.9%). The incidence of rectal mucosal prolapse was significantly greater in Group B (4.1%); (A: 0%, p = 0.02). Conclusions: Although the outcomes of TAEPT were comparable in both groups, rectal mucosal prolapse was significantly frequent in patients in whom the commencing point was < 5 mm from the DL. Type of study: Retrospective study Level of evidence: Level III
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U2 - 10.1016/j.jpedsurg.2019.08.035
DO - 10.1016/j.jpedsurg.2019.08.035
M3 - Article
C2 - 31727384
AN - SCOPUS:85075468286
SN - 0022-3468
VL - 54
SP - 2546
EP - 2549
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 12
ER -