El-Mefleh Naser, Nakwan Aya
Department of Pediatric Surgery, Shafaq Hospital for Women and Children, Idlib, Syria; Department of Pediatric Surgery, Al Hekma Hospital, Aleppo, Syria.
Free Aleppo University, Aleppo, Syria.
Int J Surg Case Rep. 2025 Jun;131:111407. doi: 10.1016/j.ijscr.2025.111407. Epub 2025 May 4.
Hirschsprung disease (HD) is commonly managed by single-stage transanal pull-through (SS-TAPT). While effective, the classical technique involves time-consuming steps, including stay sutures for mucosal traction. We present a simplified SS-TAPT approach that omits stay sutures (sutureless traction technique), reducing operative time.
A retrospective study of 26 infants (age 2-12 months) undergoing SS-TAPT without stay sutures at three hospitals (2022-2024). The transition zone was identified preoperatively (contrast enema) or intraoperatively in 17 cases.
Median operative time was 55 min (range: 50-80), with resected segments measuring 7-25 cm. All patients resumed oral feeding within 1-3 days. At a mean follow-up of 21 months, no complications (strictures, leaks) were observed.
Sutureless traction technique simplifies SS-TAPT, shortening operative time and maintaining safety. Long-term continence assessment is ongoing.
先天性巨结肠症（HD）通常采用一期经肛门拖出术（SS-TAPT）进行治疗。虽然该经典技术有效，但涉及耗时的步骤，包括用于黏膜牵引的留置缝线。我们提出一种简化的SS-TAPT方法，省略留置缝线（无缝线牵引技术），从而减少手术时间。
对三家医院（2022 - 2024年）26例接受无留置缝线的SS-TAPT手术的婴儿（年龄2至12个月）进行回顾性研究。17例术前（造影灌肠）或术中确定了移行区。
中位手术时间为55分钟（范围：50 - 80分钟），切除肠段长度为7 - 25厘米。所有患者在1 - 3天内恢复经口喂养。平均随访21个月，未观察到并发症（狭窄、渗漏）。
无缝线牵引技术简化了SS-TAPT，缩短了手术时间并保持了安全性。正在进行长期控便评估。
