Staged laparoscopic-assisted pull-through for Hirschsprung's disease.

Department of Pediatric Surgery, K.M. School of Postgraduate Medicine & Research, N.H.L. Municipal Medical College, V.S. Hospital, Ahmedabad, India.
Journal of Pediatric Surgery (Impact Factor: 1.39). 12/2003; 38(11):1667-9. DOI: 10.1016/S0022-3468(03)00586-4
Source: PubMed


The authors report 3 cases of Hirschsprung's disease that were treated by laparoscopic-assisted transanal pull-through after a colostomy already had been performed. Two of these patients presented with severe enterocolitis, and a primary laparoscopic-assisted single-stage transanal pull through was not feasible. The third patient had a colostomy performed and was referred to us for a definitive procedure. Many centers over the world now perform laparoscopic-assisted single-stage pull-through as a primary modality of management for Hirschsprung's disease. But for a country like India, where patients with Hirschsprung's disease present or are referred late and frequently with enterocolitis, performing a primary procedure is not possible in all cases. However, this has been used as the definitive procedure after performing a diverting colostomy and histopathologic determination of the length of the aganglionic bowel. The procedure gives excellent results and permits early postoperative feeding, early hospital discharge, and good cosmetic results.

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