Laparoscope-Assisted Heart-Shaped Anastomosis for Hirschsprungs Disease.


eMediNexus    14 March 2018

A recent study published in the Journal of Laparoendoscopic & Advanced Surgical Techniques aimed to determine the long-term effects of laparoscope-assisted heart-shaped anastomosis (LHSA) in comparison with the laparoscope-assisted Soave procedure (LSP). This retrospective study investigated the symptoms of chronic constipation and soiling in 56 patients with Hirschsprungs Disease (HD) after LHSA and 54 patients after LSP, between 2005 and 2011. The median age at surgery was 1.4 years for LHSA, and the median follow-up time was 7.1 years. For LSP, the median age at surgery was 1.2 years and the median follow-up time was 7.0 years. It was noted that constipation was less frequent after LHSA than after LSP. However, there was no difference in the frequency of soiling after LHSA compared to that after LSP. From the results, it was stated that improved anastomosis (LHSA) preserves most of the internal anal sphincter, and the wide anastomosis prevents stenosis as well. In the long-term follow-up, the incidence of constipation after LHSA declined when compared to that after LSP, and soiling showed a satisfactory result. Thus, it was suggested that utilizing the LHSA method to manage the affected bowel provides satisfactory long-term outcomes, vis, avoiding constipation and soiling, and that LHSA may provide a new choice for HD operations.

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