Evaluation of Trans-Anal Endorectal Pull-Through Outcomes in Hirschsprung's Disease in Different Age Groups: A Comprehensive Systematic Review

The timing of trans-anal endorectal pull-through (TAEPT) for Hirschsprung's disease (HD) is controversial. Early endorectal pull-through avoids the occurrence of preoperative enterocolitis. However, delayed pull-through (≥31 days) enables postnatal maturation of the anal canal and sphincter com...

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Veröffentlicht in:Archives of Iranian medicine 2024-07, Vol.27 (7), p.392-399
Hauptverfasser: Ghasemi Meidansar, Farshid, Moradi, Mohammad, Nabipoorashrafi, Seyed Ali, Nasiri, Seyyed Javad, Chavoshi, Tahereh, Aldraji, Mohammad, Jahangiri, Fariba
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container_end_page 399
container_issue 7
container_start_page 392
container_title Archives of Iranian medicine
container_volume 27
creator Ghasemi Meidansar, Farshid
Moradi, Mohammad
Nabipoorashrafi, Seyed Ali
Nasiri, Seyyed Javad
Chavoshi, Tahereh
Aldraji, Mohammad
Jahangiri, Fariba
description The timing of trans-anal endorectal pull-through (TAEPT) for Hirschsprung's disease (HD) is controversial. Early endorectal pull-through avoids the occurrence of preoperative enterocolitis. However, delayed pull-through (≥31 days) enables postnatal maturation of the anal canal and sphincter complex. The aim of this study was to identify the best age to perform trans-anal pull-through according to the literature. This is a comprehensive systematic review. All articles published from 2010 to 2022 were searched in the Web of Science, Ovid Medline, PubMed, CINAHIL, and Embase databases, using the keywords HD, delayed or early treatment, trans-anal pull-through surgery, age, sex or gender, complications and outcomes. Articles that met the inclusion criteria with good to fair quality according to the Newcastle-Ottawa quality assessment and low bias score in the Cochran collaboration tool were reviewed. Sixteen studies were eligible to be reviewed. The overall results of this study showed that due to more common short-term complications at neonatal period and lower contrast enema diagnostic accuracy in determining the transition zone, it seems to be reasonable decision to postpone surgery until the child is several months old. There was also no difference in terms of complications and outcomes of trans-anal pull-through surgery between females and males. It is not recommended to delay surgery too much for ages over 1 year. Ages between 3 and 12 months can be a good time for interventional treatment for HD.
doi_str_mv 10.34172/aim.28183
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Early endorectal pull-through avoids the occurrence of preoperative enterocolitis. However, delayed pull-through (≥31 days) enables postnatal maturation of the anal canal and sphincter complex. The aim of this study was to identify the best age to perform trans-anal pull-through according to the literature. This is a comprehensive systematic review. All articles published from 2010 to 2022 were searched in the Web of Science, Ovid Medline, PubMed, CINAHIL, and Embase databases, using the keywords HD, delayed or early treatment, trans-anal pull-through surgery, age, sex or gender, complications and outcomes. Articles that met the inclusion criteria with good to fair quality according to the Newcastle-Ottawa quality assessment and low bias score in the Cochran collaboration tool were reviewed. Sixteen studies were eligible to be reviewed. The overall results of this study showed that due to more common short-term complications at neonatal period and lower contrast enema diagnostic accuracy in determining the transition zone, it seems to be reasonable decision to postpone surgery until the child is several months old. There was also no difference in terms of complications and outcomes of trans-anal pull-through surgery between females and males. It is not recommended to delay surgery too much for ages over 1 year. Ages between 3 and 12 months can be a good time for interventional treatment for HD.</description><identifier>ISSN: 1029-2977</identifier><identifier>EISSN: 1735-3947</identifier><identifier>DOI: 10.34172/aim.28183</identifier><identifier>PMID: 39072388</identifier><language>eng</language><publisher>Iran: Academy of Medical Sciences of I.R. 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The overall results of this study showed that due to more common short-term complications at neonatal period and lower contrast enema diagnostic accuracy in determining the transition zone, it seems to be reasonable decision to postpone surgery until the child is several months old. There was also no difference in terms of complications and outcomes of trans-anal pull-through surgery between females and males. It is not recommended to delay surgery too much for ages over 1 year. 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subjects Age Factors
Anal Canal - surgery
Child, Preschool
Female
Hirschsprung Disease - surgery
Humans
Infant
Infant, Newborn
Male
Postoperative Complications
Systematic Review
Transanal Endoscopic Surgery - methods
Treatment Outcome
title Evaluation of Trans-Anal Endorectal Pull-Through Outcomes in Hirschsprung's Disease in Different Age Groups: A Comprehensive Systematic Review
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