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Archivos de Pediatría del Uruguay

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Abstract

PEREZ BILLI, Luis E et al. Primeros casos nacionales del tratamiento de la enfermedad de Hirschsprung con el descenso transanal endorrectal de De la Torre-Mondragón. Arch. Pediatr. Urug. [online]. 2009, vol.80, n.1, pp. 5-10. ISSN 0004-0584.

We comunicate our first six Hirschsprung disease cases which underwent surgery by transanal endorectal pull-through (TEPT) procedure, between March 2004 to March 2007, from one month to seven months of age. Four males and two girls were evaluated by radiological and histopathogic studies. The preoperative preparation consisted of whole bowel irrigation and/or enemas, and antibiotics. The classic Hirschsprung disease presentation was the rule in all cases. Intraoperative biopsies were made to identify the normal colon. The aganglionar colon taken out was between 15 and 22 cms.130 minutes was the average surgery time. All patients had spontaneous evacuations in the first 24 hours after surgery and they were fed in the following 24 to 48 hours. Two patients needed blood transfusion in the postoperative period. The average hospitalization period was 7.5 days. The follow-up varied from 17 to the 36 months, with an average of 29.5 months All patients had daily depositions at the moment and they had not presented complications. In the series there was no morbi-mortality. The procedure offers excellent cosmetic results when laparotomy or laparoscopy was avoided. The risks of abdominal contamination and adhessions are mitigated. It has more advantages for the patient because the solution is reached with a single procedure. It is also less expensive. We believe that this technique is very practical and useful especially for the classic presentation of the illness. Also, the application at early ages (newborns and infants) allowed us to correct the pathology with a short procedure which has a quick recovery, just as it happened to our cases.

Keywords : HIRSCHSPRUNG DISEASE-surgery;  DIGESTIVE SYSTEM SURGICAL PROCEDURES.

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