Document Detail

Comparison of the postoperative bowel function between transanal endorectal pull-through and transabdominal pull-through for Hirschsprung's disease: a study of the feces excretion function using an RI-defecogram.
MedLine Citation:
PMID:  19693519     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Herein, we compared the bowel function after a transabdominal and a transanal procedure for Hirschsprung's disease (HD) using the clinical score and a quantitative evaluation of the feces excretion function based on the findings of an RI-defecogram. MATERIALS AND METHODS: The subjects included 35 patients with short segment aganglionosis. In the two groups with transabdominal Z-shaped anastomosis (open group) and transanal endorectal pull-through (TEPT) (transanal group), the postoperative bowel function were evaluated based on the clinical score. In the RI-defecogram study, a time-activity curve was drawn for the (99m)Tc remaining in the rectum on defecation. The feces excretion function was thus quantified, with the time until the (99m)Tc in the rectum became 50% as T0.5 and the time until 90% of the feces were excreted from the rectum as T0.9. RESULTS: The clinical score could be evaluated in 9 cases in the open group and in 15 cases in the transanal group. No significant difference was observed in the total clinical score between the two groups, but the urge to defecate and the constipation scores in the subcategories were significantly lower in the open group. The defecogram was performed included seven cases in the open group and five cases in the transanal group. When an analysis of covariance of the two groups was conducted for the T0.5 and T0.9 values using the postoperative months as a covariate, there was a significantly negative slope, and moreover, there was a significant difference between the two groups. CONCLUSIONS: The RI-defecogram showed that feces excretion time improves with the postoperative months in both the groups, but the transanal group has higher feces excretion function in the early postoperative period compared with the open group. We consider the RI-defecogram to therefore be a useful examination method for evaluating the feces excretion function.
Miyuki Kohno; Hiromichi Ikawa; Kunio Konuma; Hiroaki Masuyama; Hironori Fukumoto; Eri Ogawa; Takahiro Oshikiri; Sadayoshi Takahashi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pediatric surgery international     Volume:  25     ISSN:  1437-9813     ISO Abbreviation:  Pediatr. Surg. Int.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-16     Completed Date:  2010-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8609169     Medline TA:  Pediatr Surg Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  949-54     Citation Subset:  IM    
Department of Pediatric Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan.
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MeSH Terms
Child, Preschool
Digestive System Surgical Procedures / methods
Hirschsprung Disease / surgery*
Intestines / physiology*
Radiopharmaceuticals / diagnostic use
Technetium / diagnostic use
Reg. No./Substance:
0/Radiopharmaceuticals; 7440-26-8/Technetium

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