Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Hirschsprung disease is a common cause of neonatal and children intestinal obstruction. Diagnosis require, history taking, examination, contrast enema study and rectal biopsy. Traditionally, treatment of Hirschsprung disease (HD) had consisted of a colostomy at diagnosis followed by one of a variety of pull-through procedures as a multistage approach. One stage endorectaltransanalpullthrough is now favored in many centers worldwide with results as favorable as multistage procedures, and there may be a cost advantage as well. As this approach is not including any intra-abdominal or pelvic dissection, and doesn{u2019}t require laparotomy or laparoscopy, and has good cosmetic results. Problems with residual aganglionic (the muscular cuff) tissues in transanalendorectalpullthrough procedure, and concern of recurrence of symptoms of Hirschsprung with growth of these residual tissues as the patient grow, made some centers to try a transanalSwenson approach, with the label of the era (Swenson Revisited Transanally) Our results confirmed that the SwensonTrans-anal pullthroughis a safe and effective alternative for treatment of HD, with comparable results to the more established transanalendorecatalpullthrough procedure, without increased incidence of urological problems, or intraoperative injury of surrounding vital structures. The technique can even be easier than transanalendorectalpullthrough procedure

Issued also as CD