ADOPTING TRANSANAL SWENSON PULL-THROUGH FOR HIRSCHSPRUNG DISEASE IN PESHAWAR, PAKISTAN

Abstract

Hirschsprung's disease (HD) has been recognized as one of the leading causes of intestinal blockage in children. Children who are affected typically present with intestinal blockage in the days following delivery. Even with surgical advancements, long-term results are still unpredictable. This study highlights the significance of long-term patient follow-up to rapidly detect and treat these problems.  The purpose of the research was to provide light on the use of Transanal Swenson Pull-Through (TSPT) in the treatment of patients with Hirschsprung's disease, concentrating on characteristics such as operating time, postoperative problems, length of hospital stay, and overall patient results. Post-surgical problems with pathologically proven Hirschsprung's disease were examined in children in age between 0 to 15 years. 72 patients were assessed across four unique periods: one month, one month to one year, one year to five years, and more than five years. Participants were restricted to those having a biopsy-confirmed diagnosis of classical or short-segment Hirschsprung's disease. Utilizing the Defaecation and Faecal Continence questionnaire, functional results were evaluated in accordance with the Rome IV criteria. It focuses primarily on seven major problems: Anastomotic Leak, Stricture, Frequent stooling/faecal incontinence, Persistence of symptoms, Transition zone pull through, Post-Operative Enterocolitis, and Reoperation. The most prevalent consequence was Stricture, while Anastomotic Leak was quite uncommon. Frequent bowel movements and faecal incontinence were most common in the initial postoperative period. Persistent symptoms were the least prevalent, but their long-term influence on patient quality of life was a considerable issue. Post-Operative Enterocolitis was more prevalent in the intermediate to long-term durations.