Transanal endorectal pull-through for Hirschsprung's disease: experience with 50 patients

Transanal endorectal pull-through (TEPT) is the latest advancement in the treatment of Hirschsprung's disease (HD). The aim of this study was to evaluate the safety and efficacy of TEPT as a definitive treatment for patients with HD. A retrospective study of 50 patients who underwent TEPT at Uludag University, Bursa, Turkey, between June 2001 and April 2012 was conducted. These patients were evaluated with regard to their age, sex, preoperative findings, and length of the aganglionic segment, intraoperative and postoperative complications, and results of the follow-up. Forty-three patients were boys and seven were girls. The median age was 3 months (range 0-96 months). The most common symptoms were abdominal distention and vomiting. HD was diagnosed in 38 patients using barium enema and anorectal manometry, in 11 patients using rectal biopsy, and in 1 patient using laparotomy with biopsy. The mean time from the beginning of enteral feeding was 2.2 +/- 1.1 days. The mean follow-up period was 26.7 +/- 20.8 months. The postoperative complications included transient perianal excoriation in 12 patients, enterocolitis in 10, anastomotic stricture in 3, soiling in 3, recurrent constipation in 2, prolapse of the pulled through colon in 1, anastomotic leak in 1, and rectovestibular fistula in 1 patient. TEPT is a feasible and safe procedure in children with rectosigmoid HD.