بررسی عوارض جراحی تک مرحله‌ایTransanal Endorectal Pull Through در نوزادان مبتلا به بیماری هیرشپرونگ

Introduction: Hirschsprung's disease(HD) is a common congenital disease. In 80% of cases, the recto sigmoid junction is involved. Recently, one-stage transanal endorectal pull-through(TAEPT) procedure has been popular, but it could have several complications. In this research, we have studied the complications of this procedure. Methods: During a four year period, 86 infants clinically suspected to have HD were admitted at our center. HD was confirmed by rectal biopsy and all were candidates for TAEPT operation. A Swenson-like procedure was performed and in 30 cases, prophylactic Hegar dilatation was done 2 weeks after operation. Results: Anal stricture was seen in 12 cases(14%) of which 10 cases were treated by anal dilation and 2 cases were corrected by surgical management. Entrocolitis was seen in 4 cases(5%) who were treated by medical management. In 2 cases, retrocolic abscess was present that was treated by spontaneous drainage via tube drain. There was no anastomotic stricture after starting prophylactic anal bouginage. Conclusion: TAEPT has many advantages and few complications. It seems that one of the most common complications is anastomotic stricture that responds well to prophylactic bouginage. We recommend prophylactic anal bouginage with Hegar probe 2 weeks after operation. A long-term follow-up is needed to evaluate the outcomes of these operations.