Date Approved

1999

Graduate Degree Type

Thesis

Degree Name

Physical Therapy (M.S.)

Degree Program

Physician Assistant Studies

Abstract

Hirschsprung’s Disease (HD), congenital megacolon, in infants has been historically treated by a multiple stage surgical process. Initial diagnosis is made by a rectal biopsy followed by a diverting colostomy, subsequent pull-through procedure and finally a colostomy take-down. In recent years, a single-stage primary endorectal pull-through (PERPT) has been advocated. Advantages include a single operation with potentially equal or fewer complications. Whether a PERPT is superior to a staged procedure is yet to be proven.

The purpose of this study was to retrospectively compare the incidence of enterocolitis (EC), the most significant complication of HD in those who underwent the Soave PERPT to those who underwent the conventional two-stage surgical treatment for this anomaly.

We hypothesized that the incidence of EC was less in children who underwent the Soave PERPT procedure compared to those who underwent the conventional two-stage surgical treatment for HD.

The incidence of the primary outcome measure (EC) was compared with those who underwent the two-stage procedure in a historical control utilizing Chi-square analysis.

Secondary outcome measures, which include complications (early and late), stricture formation (anastomotic and cuff), continence (stool and urinary), frequency of defecation, soiling, constipation (initial and long-term) and mortality rates, were also reported.

Comments

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