Comparison Outcome of Patients with Rectal Tube and Without Rectal Tube Post Swenson Like Pull-Through Transanal Procedure at RSUP Prof Dr. I G.N.G. Ngoerah

Abstract

Background: Surgical management of patients with Hirschsprung’s disease has experienced a significant improvement in getting a better outcome. This procedure can lead to complications of postoperative obstructive symptoms and anastomotic leaks and can affect the length of postoperative care. It is necessary to consider inserting a rectal tube or non-rectal tube after surgery to prevent complications. Objective: To determine the difference in patient outcomes with Hirschsprung’s disease between installing a rectal tube or non-rectal tube after Transanal Swenson-like pull-through surgery. Methods: This study uses a prospective observational design, with an actual experiment with a single-masked randomized study design. It involved 50 samples of patients with Hirschsprung’s disease at Prof. Dr. I.G.N.G. Ngoerah Denpasar from August 2021 to July 2022. Results: There were no obstructions (0%) and no anastomotic leaks (0%) in patients with a rectal tube and without a rectal tube post transanal Swenson-like pull-through procedure; there was no statistically significant difference. Length of stay was obtained from data on patients who had rectal tubes installed with an average value of 4.5 days (SD: 1.1) longer than the length of stay of patients without rectal tubes, obtained an average value of 2.2 days (SD: 0.4) with a mean difference of 2.3 days. The p-value was obtained at 0.000<0.05. Conclusion: There is no difference in obstruction and anastomotic leakage incidence in patients with rectal tube placement and non-rectal tube post-transanal Swenson-like pull-through procedure. The length of stay for patients with non-rectal tube post-transanal Swenson-like pull-through procedures is shorter than those with a rectal tube, so it can reduce the use of financing for hospital care, and patients do not need to use a rectal tube for home care.