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Association of Paediatric Surgeons of Bangladesh
Journal of Paediatric Surgeons of Bangladesh
Original Articles · Vol. 9 No. 1-2 (2018)

Laparoscopic assisted transanal pull through and Duhamel pull through for the treatment of short segment Hirschsprung’s disease: A comparative study of outcome

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JPSB
Journal of
Paediatric Surgeons of Bangladesh
Published : July 2018
CONTENTSVolume 09Number 1 & 2January - July 2018
Editorial
Surgical care in birth defects
Tahmina Banu
01
Review Articles
Operative complications of urogenital tract during repair of anorectal malformation (ARM) in boys: A review
Md Samiul Hasan, Ashrarur Rahman
44
Original Articles
Role of USG and diuretic renogram in evaluation of outcome in children after Anderson-Hynes dismembered pyeloplasty for unilateral PUJ obstruction
Ipsita Biswas, Abhi Kumar Chakraborty, Ayub Ali, Gajendra Nath Mahato
03
Evaluation of testis sparing surgery in paediatric testicular tumor
Partha Sarathy Majumder, Anuradha Karmaker, Syed Abdul Adil, Ashfaque Nabi, Jaglul Gaffer Khan, Kaniz Hasina, Abdul Hanif Tablu
08
Outcome of posterior versus anterior sagittal ano-rectoplasty in patients of anorectal malformation (ARM) with vestibular fistula
Ayesha Sadia, Md Khurshid Alam Sarwar, Tanzil Farhad, Tanvir Kabir Chowdhury
13
Laparoscopic assisted transanal pull through and Duhamel pull through for the treatment of short segment Hirschsprung’s disease: A comparative study of outcome
Shah Md Ahsan Shahid, Md Nowshad Ali, Khondokar Seheli Nasrin, Shantona Rani Paul, Md Zamil Hossain
21
Abdominal trauma in children: Experience from north-west region of Bangladesh
Md Zamil Hossain, Md Nowshad Ali, Amar Kumar Saha, S M Ahsan Shahid, Shantona Rani Paul
28
Inguinal herniotomy in children with and without peri-operative chemoprophylaxis
Md Mizanur Rahman, Shahnoor Islam, Md Moinul Huque
33
Outcome of circumcision in children with or without antibiotics in a tertiary Hospital
Supratim Howlader, Khandker Md Raihan Hossain, Saiful Ahmed, Afruzul Alam, Md Asif Iqbal, Mahmudul Hasan, Ainun Ahmed, Sahadat Hossain
39
Case Reports
Benign Phyllodes tumor in an 11-year-old premenarchal girl
Shahnoor Islam, AKM Amirul Morshed, A H M Abdul Hai, Tania Akter
50
Razor blade ingestion in an infant: A case report
Nazmul Islam, Refoyez Mahmud, Md Samiul Hasan, Ashrarur Rahman
53
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ASSOCIATION OF PAEDIATRIC SURGEONS OF BANGLADESH (APSB)
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Authors

  • Shah Md Ahsan ShahidAssoc. Professor. Dept. of Paediatric Surgery, Rajshahi Medical College, Bangladesh.
  • Md Nowshad AliProfessor & Head, Dept. of Paediatric Surgery, Rajshahi Medical College, Bangladesh.
  • Khondokar Seheli NasrinAsst. Professor. Dept. of Obs & Gynae, Rajshahi Medical College, Bangladesh.
  • Shantona Rani PaulAsst. Professor. Dept. of Paediatric Surgery, Rajshahi Medical College, Bangladesh.
  • Md Zamil HossainDept. of Paediatric Surgery, Rajshahi Medical College Hospital, Bangladesh.

Keywords

Hirschsprung’s disease Laparoscopic assisted transanal pull through Duhamel pull through

Abstract

Background: The goal of surgical management for Hirschsprung’s disease is to remove the aganglionic bowel and reconstruct the intestinal tract by bringing the normally innervated bowel down to the anus while preserving normal sphincter function. Objectives: Present study aimed to determine a better procedure of pull through operative procedure for Hirschsprung’s disease by a randomized comparison. Patients and Methods: This interventional study was performed in the department of Paediatric Surgery, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, over a period of one year (from March 2022 to April 2023). A total of 53 patients who were suffering from short segment Hirschsprung’s disease, were included in present study as per inclusion and exclusion criteria and randomized into two groups under study, namely; Laparoscopic assisted transanal pull-through and Duhamel pull-through operations. Primary outcome measured by persistent obstructive symptoms, anastomotic strictures, persistent or acquired aganglionosis and fecal incontinence. Results: Early per operative and postoperative complications, including bleeding, infection, injury to adjacent organs were not troublesome but differences in two groups under study, were significant and findings were in favour of laparoscopic procedure. Persistent obstructive symptoms and aganglionosis occurred in greater percentage in Duhamel procedure but anastomotic strictures and fecal incontinence were commoner in percentage in the laparoscopic variant. Conclusion: The advantages of laparoscopic assisted transanal pull-through include its improved cosmesis, reduced hospital costs, hospital stay, operating time. But anastomotic strictures and fecal incontinence remain as a critical issue for long term outcome.

Journal of Paediatric Surgeons of Bangladesh (2018) Vol. 9 (1 & 2): 21–27

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