Treatment of Hirschsprung’s disease in young children

Abstract

Objective. The objective of this study was to optimize the treatment for Hirschsprung’s disease in young children.Material and methods. A total of 71 children, ranging in age from 3 days to 3 years, were observed. Patients were categorized into three groups based on the surgical procedure performed: 23 underwent transanal endorectal proctoplasty according to De La Torre Mondragon (32.4%), 17 according to the Swenson-like method (23.9%), and 31 according to Soave-Lenyushkin (43.7%).Results and discussion. The results of the maternal examination revealed the presence of cytomegalovirus, herpes virus and toxoplasmosis. The basis for the success of surgical treatment is timely diagnosis. After surgical intervention, histological examination of the surgical material confirmed intestinal agangliosis. Peritoneal-promesenteric proctoplasty according to SoaveLenyushkin in the modification of the clinic, with wedge-shaped excision of the serous-muscular case, is effective in terms of prevention of inter-sheath hematomas and fluid accumulation. The De La Torre-Mondragon and Swenson-like technique of transanal endorectal relegation, without abdominal access with demucosation of the rectum, is considered an effective and minimally invasive access for rectal and rectosigmoidal forms of Hirschsprung’s disease.Conclusions. Transanal endorectal relegation at an early age in children showed rapid recovery of intestinal motility in the postoperative period without skin incision. The results of early surgical intervention contribute to the achievement of good results in the immediate and distant period after the surgical intervention.