Laparoscopic assisted versus complete transanal pullthrough in management of Hirschsprung’s Disease: A short term comparative study

Abstract

Background: It is unclear whether laparoscopic-assisted transanal pull-through (LATP) or complete transanal pull-through (CTP) is superior for the surgical management of Hirschsprung’s disease. The aim of the present work was to compare outcomes between both approaches.Methods: We prospectively collected the relevant data about patients with Hirschsprung’s disease who underwent LATP or CTP at our center from July, 2017 to July, 2019. Patients were matched based on age, birth weight, and level of aganglionosis. The study included 22 patients with Hirschsprung disease divided randomly into two groups. Group I was operated by complete transanal pullthrough (CTP) and group II was operated by laparoscopic assisted technique (LATP).Results: From our data, there was no statistical difference in length of stay or incidence of postoperative complications. Our pooled analysis of comparative studies including our results showed that operative time was significantly longer for the LATP group. Moreover, blood loss was significantly lower in the laparoscopic assisted group.Conclusion: Clinical outcomes are comparable between LATP and CTP regarding post-operative complications and hospital stay. However, CTP offers shorter operative time and laparoscopic assisted offers less blood loss.