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Single-Stage Transanal Pull-Through for Hirschsprung’s Disease: A 60 Cases Study in Al-Kafeel Hospital in Karbala City

Vol. 2 No. 3 (2025): Desember:
DOI : https://doi.org/10.21070/ijhsm.v2i3.330
Published : Dec 15, 2025

Sarmad Jaafar Mohammed Alrubaye (1)

(1) College of Medicine, University of Al-Ameed, Kerbala, Iraq
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Abstract:

Background: Hirschsprung's disease (HD) represents a congenital disorder characterized by intestinal aganglionosis, traditionally requiring multi-stage surgical interventions with significant morbidity. Specific Background: Single-stage transanal pull-through (TAPT) has emerged as a minimally invasive alternative, offering reduced surgical trauma and faster recovery. Knowledge Gap: However, comprehensive data regarding TAPT outcomes in Middle Eastern pediatric populations remain limited, particularly concerning postoperative complications and functional results. Aims: This study evaluated the safety, efficacy, and clinical outcomes of single-stage TAPT in 60 pediatric HD patients treated at Al-Kafeel Hospital, Karbala, Iraq, between July 2022 and November 2025. Results: The cohort comprised 31 males (52%) and 29 females (48%), with rectosigmoid involvement predominating (80%). Mean operative duration was 85±22 minutes without intraoperative complications. Early postoperative complications included perianal excoriation (22%), enterocolitis (15%), anastomotic edema (12%), and sphincter spasm (8%). Long-term follow-up demonstrated satisfactory bowel function with minimal intervention requirements (3%). Novelty: This represents one of the largest single-center Middle Eastern series documenting TAPT outcomes with comprehensive postoperative assessment. Implications: TAPT demonstrates excellent safety profiles and functional outcomes, supporting its adoption as the preferred surgical approach for HD in specialized pediatric centers.
Highlight :



  • TAPT showed high safety with no intraoperative complications in 60 cases and 85-minute average operative time.

  • Rectosigmoid involvement occurred in 80% of cases with manageable postoperative complications like perianal excoriation (22%) and enterocolitis (15%).

  • Favorable long-term outcomes with minimal interventions support TAPT as an effective minimally invasive approach.


Keywords : Hirschsprung's Disease, Transanal Pull-Through, Pediatric Surgery, Congenital Aganglionosis, Minimally Invasive Procedure

References

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