Paediatric Surgery (Ukraine).2022.4(77):40-49; doi 10.15574/PS.2022.77.40
Prytula V. P.^1,2, Kurtash O. O.³, Hussaini S. F.^1,2, Rusak P. S. ^4
1Bogomolets National Medical University, Kyiv, Ukraine
²National Children’s Specialized Hospital «OKHMATDYT», Kyiv, Ukraine
³Ivano-Frankivsk National Medical University, Ukraine
⁴Shupyk National Healthcare University of Ukraine, Kyiv

For citation: Prytula1 VP, Kurtash OO, Hussaini SF, Rusak PS.  (2022). Comparative characteristics of the results of surgical treatment of Hirschsprung’s disease in children depending on the method of surgical correction. Paediatric Surgery (Ukraine). 4(77): 40-49; doi 10.15574/PS.2022.77.40.
Article received: Oct 01, 2022. Accepted for publication: Des 20, 2022.

For the Treatment of Hirschsprung’s disease (HD) in children’s, different methods of open and minimally invasive surgical correction are used. However, up to 40.4% of operated patients get complications that require secondary correction or repeated radical interventions, regardless of the primary method of correction.
Purpose – to compare the results of surgical treatment of HD in children depending on the method of surgical correction.
Materials and methods. An analysis of the surgical treatment of 1,187 children with various forms of HD aged from birth till 18 years old was conducted from 1980 to the end of 2021. The rectal form of HD was seen in 386 (32.52%) patients, 598 (50.38%) rectosigmoid., subtotal – 162 (13.65%) and 41 (3.45%) patients had a total form of aganglionosis. All patients were operated by either «classical» open approach or minimally invasive radical methods. Early and long-term complications after various methods of surgical correction of HD, their cause and options for appropriate correction were studied.
Results. In the early postoperative period, 51 (4.30%) of 1187 operated patients were diagnosed with such complications as intestinal obstruction (n=7 (0.59%)), intestinal intussusception (n=3 (0.25%)), suppuration of the postoperative wound at the place of removal of the intestinal stoma (n=5 (0.42%)), hematoma of the inter-cuff space (n=3 (0.25%)), abscess of the inter-cuff space (n=9 (0.76%)), retraction of pull through colon (n=2 (0.17%)), anastomotic leak (n=7 (0.59%)) and anastomotic stenosis (n=15 (1.26%)). In 9 (0.76%) children we noted stenosis of the colo-anal anastomosis, and in 6 (0.51%) patients – stenosis of the ileo-anal anastomosis. Long-term postoperative complications were noted in 48 (4.04%) patients: anastomotic stenosis (n=16 (1.35%)), «Duhamel pouch» (n=2 (0.17%)), residual aganglionosis (n=23 (1.94%)), colonoptosis (n=1 (0.08%)) and adhesive intestinal obstruction (n=6 (0.51%)). All complications were detected in a timely manner and corrected accordingly.
Conclusions. When treating HD in children, complications may occur in the early and long-term postoperative periods after using any approach open or minimally invasive methods of radical correction. The Soave-Boley operation and minimally invasive techniques are the safest methods of radical correction of HD in children. Timely detection and appropriate correction of early or long term postoperative complications improves the functional results of surgical treatment of HD in children.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
Keywords: Hirschsprung’s disease, children, surgical treatment, results, complication.

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