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Abstract
Objectifs. Décrire la technique opératoire, les difficultés et les résultats de la chirurgie de la maladie de Hirschsprung par voie transanale dans un groupe d’enfants sénégalais. Patients et méthodes. L’étude a été réalisée entre le premier janvier 2010 et le 31 décembre 2015 au service de chirurgie pédiatrique du centre hospitalier d’enfants Albert Royer de Dakar. Vingt un enfants d’âge compris entre deux et quinze ans ont été opérés de maladie de Hirschsprung par voie transanale. Nous avons revu leurs dossiers et étudié la technique opératoire, les difficultés éventuelles et les résultats de l’intervention chirurgicale six et 12 mois après l’opération. Résultats. Les complications hémorragiques et des problèmes de congruence entre l’anus et le colon descend ont été notés chez els enfants qui ont eu un abaissement colique sans colostomie préalable. Les suites opératoires ont été simples dans 14 cas et des complications nt été notées chez sept enfants. Six mois après l’opération, les résultats étaient satisfaisants dans 15 cas et des complications ont été notées chez six enfants, dot un décédé. Douze mois après la chirurgie, les résultats restaient satisfaisants pour 15 enfants et des complications ont été notées chez cinq autres, dont deux décès. Conclusion. La chirurgie transanale dans la maladie de Hirschsprung est possible chez le grand enfant. Pour obtenir des résultats satisfaisants, il est nécessaire de réalise une colostomie préalable.
ABSTRACT
Purpose. To report the intraoperative difficulties and results of transanal pull-through in Hirschsprung disease in children aged 2 to 15 years in Dakar. Patients and methods: Between 1 January 2010 and 31 December 2015, 21 children between the ages of 2 and 15 years had a transanal surgery in Hirschsprüng disease. We studied the intraoperative difficulties and the postoperative treatment outcomes at six months and 12 months. Results. Hemorrhage and congruence problems between the lowered colon and the anus were noted in patients who had lowered without a previous colostomy. The operative outcomes were simple in 14 cases and complicated in 7 cases. At six-month there was resulted in a favorable outcome in 15 cases and complications in six cases, including one death. At 12 months, there was a favorable outcome in 15 cases and complications in five cases, including two deaths. Conclusion. Transanal surgery is a technique that can be offered to older children. However, its realization requires the prior colostomy to improve the results.
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References
- . Hackam DJ, Reblock KK, Redlinger RE, Barksdale EM Jr. Diagnosis and outcome of Hirschsprüng’s disease: does age really matter ? Pediatr Surg Int 2004;20(5):319-322. https://doi.org/10.1007/s00383-004-1188-5.
- . Ekenze SO, Ngaikedi C, Obasi AA. Problems and outcome of Hirschsprüng’s disease presenting after 1 year of age in a developing country. World J Surg 2011;35(1):22-26. https://doi.org/10.1007/s00268-010-0828-2.
- . Ademuyiwa AO, Bode CO, Lawal OA, Seyi-Olajide J. Swenson’s pull-through in older children and adults: peculiar peri-operative challenges of surgery. Int J Surg 2011;9(8):652-654. https://doi.org/10.1016/j.ijsu.2011.08.006.
- . Stensrud KJ, Emblem R, Bjørnland K. Late diagnosis of Hirschsprüng disease: patient characteristics and results. J Pediatr Surg 2012;47(10):1874-1879. https://doi.org/10.1016/j.jpedsurg.2012.04.022.
- . Shankar KR, Losty PD, Lamont GL, Turnock RR, Jones MO, Lloyd DA, and al. Transanal endorectal coloanal surgery for Hirschsprüng’s disease: experience in two centers. J Pediatr Surg 2000;35(8):1209-1213. https://doi.org/10.1053/jpsu.2000.8728.
- . Elhalaby EA, Hashish A, Elbarbary MM, Soliman HA, Wishahy MK, Elkholy A, and al. Transanal one-stage endorectal pull-through for Hirschsprung's disease: a multicenter study. J Pediatr Surg 2004;39(3):345-351. https://doi.org/10.1016/j.jpedsurg.2003.11.038.
- . Höllwarth ME, Rivosecchi M, Schleef J, Deluggi S, Fasching G, Ceriati E, and al. The role of transanal endorectal pull-through in the treatment of Hirschsprung's disease: a multicenter experience. Pediatr Surg Int 2002;18(5-6):344-348. https://doi.org/10.1007/s00383-002-0747-x.
- . Langer JC, Seifert M, Minkes RK. One-stage soave pull-through for Hirschsprüng’s disease: a comparison of the transanal and open approaches. J Pediatr Surg 2000;35(6):820-822. https://doi.org/10.1053/jpsu.2000.6849.
- . Mabula JB, Kayange NM, Manyama M, Chandika AB, Rambau PF, Chalya PL. Hirschsprüng’s disease in children: a five year experience at a university teaching hospital in northwestern Tanzania. BMC Res Notes 2014;7:410. https://doi.org/10.1186/1756-0500-7-410.
- . Kleinhaus S, Boley SJ, Sheran M, Sieber WK. Hirschsprüng’s disease: a surgery of the members of the Surgical Section of the American Academy of Pediatrics. J Pediatr Surg 1979;14(5):588-597. https://doi.org/10.1016/S0022-3468(79)80145-1.
- . Swenson O. Early history of the therapy of Hirschsprüng’s disease: facts and personal observations over 50 years. J Pediatr Surg 1996;31(8):1003-1008. https://doi.org/10.1016/S0022-3468(96)90074-3.
References
. Hackam DJ, Reblock KK, Redlinger RE, Barksdale EM Jr. Diagnosis and outcome of Hirschsprüng’s disease: does age really matter ? Pediatr Surg Int 2004;20(5):319-322. https://doi.org/10.1007/s00383-004-1188-5.
. Ekenze SO, Ngaikedi C, Obasi AA. Problems and outcome of Hirschsprüng’s disease presenting after 1 year of age in a developing country. World J Surg 2011;35(1):22-26. https://doi.org/10.1007/s00268-010-0828-2.
. Ademuyiwa AO, Bode CO, Lawal OA, Seyi-Olajide J. Swenson’s pull-through in older children and adults: peculiar peri-operative challenges of surgery. Int J Surg 2011;9(8):652-654. https://doi.org/10.1016/j.ijsu.2011.08.006.
. Stensrud KJ, Emblem R, Bjørnland K. Late diagnosis of Hirschsprüng disease: patient characteristics and results. J Pediatr Surg 2012;47(10):1874-1879. https://doi.org/10.1016/j.jpedsurg.2012.04.022.
. Shankar KR, Losty PD, Lamont GL, Turnock RR, Jones MO, Lloyd DA, and al. Transanal endorectal coloanal surgery for Hirschsprüng’s disease: experience in two centers. J Pediatr Surg 2000;35(8):1209-1213. https://doi.org/10.1053/jpsu.2000.8728.
. Elhalaby EA, Hashish A, Elbarbary MM, Soliman HA, Wishahy MK, Elkholy A, and al. Transanal one-stage endorectal pull-through for Hirschsprung's disease: a multicenter study. J Pediatr Surg 2004;39(3):345-351. https://doi.org/10.1016/j.jpedsurg.2003.11.038.
. Höllwarth ME, Rivosecchi M, Schleef J, Deluggi S, Fasching G, Ceriati E, and al. The role of transanal endorectal pull-through in the treatment of Hirschsprung's disease: a multicenter experience. Pediatr Surg Int 2002;18(5-6):344-348. https://doi.org/10.1007/s00383-002-0747-x.
. Langer JC, Seifert M, Minkes RK. One-stage soave pull-through for Hirschsprüng’s disease: a comparison of the transanal and open approaches. J Pediatr Surg 2000;35(6):820-822. https://doi.org/10.1053/jpsu.2000.6849.
. Mabula JB, Kayange NM, Manyama M, Chandika AB, Rambau PF, Chalya PL. Hirschsprüng’s disease in children: a five year experience at a university teaching hospital in northwestern Tanzania. BMC Res Notes 2014;7:410. https://doi.org/10.1186/1756-0500-7-410.
. Kleinhaus S, Boley SJ, Sheran M, Sieber WK. Hirschsprüng’s disease: a surgery of the members of the Surgical Section of the American Academy of Pediatrics. J Pediatr Surg 1979;14(5):588-597. https://doi.org/10.1016/S0022-3468(79)80145-1.
. Swenson O. Early history of the therapy of Hirschsprüng’s disease: facts and personal observations over 50 years. J Pediatr Surg 1996;31(8):1003-1008. https://doi.org/10.1016/S0022-3468(96)90074-3.