Evaluation of long term results of patients who underwent transanal endorectal pull through surgery for hirschsprung disease

Introduction and Aim: The most preferred surgical method in the treatment of Hirschsprung's disease (HH) in recent years is the transanal endorectal pull through (TERP) operation. In our study, it was aimed to evaluate the long term follow up results of patients after surgery, and to analyze the data obtained in the light of the literature in patients who were operated with the TERP method. Material and Method: The files of patients who had TERP between 2009 and 2019 at Gaziantep University Faculty of Medicine, Department of Pediatric Surgery and who were 3 years or older after surgery were reviewed. Preoperative patient information was analyzed retrospectively. The patients were invited to the outpatient clinic for the evaluation of bowel functions, continence conditions and quality of life in the postoperative period. The information of patients who could not come to control was obtained by contacting their relatives over the phone. Patients were asked questionnaire questions prepared. Results: 46 of the patients were boys and 8 were girls. The average age of diagnosis was 26,4 months and the average age of surgery was 35,5 months. The mean operation time was 140 minutes, and the aganglionic segment length was 21,5 cm on average. In the early postoperative period, anastomotic stricture was observed in 3 (5,5%) patients, and enterocolitis in 2 (3,7%) patients. Constipation was observed in 13 (24%) and soiling in 7 (13%) of the patients whose long term results were evaluated. Partial fecal incontinence was observed in 2 (3,7%) patients. Statistically, a significant difference was found between the height and weight percentile values of patients before and after surgery. The mean score of the bowel function questionnaire applied to the patients was 19,05. Conclusion: In our study, it was seen that TERP surgery was an effective and reliable method for all HH age groups. It was observed that TERP surgery can be applied to patients easily, complications are low, cosmetic results are good, and post surgery bowel movements and sphincter functions are near to normal. With these advantages of TERP surgery, it was concluded that it is a very important surgical technique for HH. Keywords: Hirschsprung disease, Constipation, Incontinence, Pull through.