CONGENITAL AGANGLIONOSIS;

SINGLE STAGE TRANSANAL PULLTHROUGH, A BIG RELIEF TO PATIENTS

Abstract

… Objective : To report early and late outcome after a one stage operation and
comparison with others similar work and to see feasibility of this procedures in our limited
resources. Patients and method: We have performed transanal pull through in department of
Paediatric Surgery, Nishtar Hospital Multan during May 2010 to May 2013. Fifty patients out of 117
were selected, older than one year, non marasmic and diagnosed as short segment
aganglionosis by barium enema were selected. Transanal Swenson’s pull through was
performed, aganglionic segment was decided on gross appearance (narrow) due to lack of
frozen section facility, anastomosis made with 4/0 vicryl. Results: Procedure completed on an
average within one hour, without any transfusion. Feeding was started from day one, manageable
complications were observed in 25% patients, no mortality seen. Hospital stay was on an
average 6 days. Conclusions: Transanal one stage pull through is very practical, can be done
without facility of frozen section.