Preliminary Results of Transanal Lowering in Hirschsprung Disease at the Service of Pediatric Surgery of Aristide Le Dantec of Dakar Hospital
Diaby S*, Fall M, Coulibaly MB, Niang S, Sangare M, Bitchoka NER, Fall AL, Gassama F, Coulibaly Y, Ngom G and Ndour O
Department of Paediatric Nutrition, Senegal
*Corresponding Author: Diaby S, Department of Paediatric Nutrition, Senegal.
May 27, 2021; Published: July 14, 2021
Introduction: The treatment of Hirschsprung disease is surgical and many surgical technics are described, of which the transanal way of De La Torre and Ortega. It actually constitute gold standard. We wished to evaluate our results of the pediatric surgery service of Aristide Le Dantec hospital of Dakar.
Patients and Methods: Through a prospective and descriptive study, we have recorded 16 files of 14 boys and two girls ages ranging from 0 - 15 years, who have benefited a transanal lowering for Hirschsprung disease from 1st April 2017 to 31st March 2018 at the pediatric surgery service of Aristide Le Dantec hospital of Dakar.
Results: The average of our patients at the intervention was of 30 months. The reach was sigmoidal recto in every case. The surgical biopsy confirmed the diagnostics in every case. All our patients benefited preoperative preparation. The installation of the patients was done by a ventral decubitus for 14 patients. A colostomy was made to a child.
The first was transanal exclusive for all of our patients with an average "cuff" length of 2 cm and the resected colic segment was 21 cm.
An accidental urethral breach occasioned at the intraoperative surgery. The food recovery was following day of the intervention for every patient and same for the transit areas. The average frequency of stools was 3 per day stools. The average time of hospitalization was of 5 days. All the patients benefited of a drop in the healthy zone according to the anatomopathological result of the exam. The nappy rash was found in 2 patients, the acute retention of urine in a patient, anal stenosis in a patient and staining in a patient. The post-surgical dilatation was done between the 10th and 15th day with a frequency of 2 reason per week in between 1 month except on a patient who consulted 30 days later. The average retreat was 6 months. We registered a death case due to ulcerative necrotizing enterocolitis.
Conclusion: We have satisfying results but need a deeper evaluation.
Keywords: Hirschsprung Disease; Child; Transanal Lowering of De La Torre and Ortega; Results
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