TY - JOUR
T1 - Redo surgery with longitudinal resection for dilated bowel in Hirschsprung disease
T2 - an illustrative case series
AU - Roorda, Daniëlle
AU - Surridge, Tessa J.
AU - Visschers, Ruben G.J.
AU - Derikx, Joep P.M.
AU - van Heurn, L. W.Ernest
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Purpose: Patients with Hirschsprung disease (HD) can have persistent obstructive symptoms after resection of the aganglionic segment. If obstructive symptoms are treated inadequately, this may lead to recurrent faecal stasis and impaction, and may result in severe distension of the bowel. A permanently distended bowel which not responds to conservative treatment may be an indication for redo surgery. The aim of this study is to describe our experiences and the short-term results of a novel technique: longitudinal antimesenteric resection with a longitudinal anastomosis. Methods: We reviewed the medical records of our three patients who underwent longitudinal resection of severe distended bowel. This technique aims to improve defecation by improving faecal passage and is characterized by resection of the antimesenteric side of the distended intestinal segment, followed by plication with a longitudinal anastomosis. In this paper, this novel technique is described in detail, as well as short-term outcomes. Results: All patients had an uneventful recovery after longitudinal antimesenteric resection. During follow-up, the functional outcomes were excellent, with a large improvement of bowel function. All patients were continent for faeces, and treated with low-dose laxatives or occasional preventive irrigation in one patient. There were no more complaints of persistent constipation or soiling. Conclusion: Longitudinal resection is a surgical redo-procedure offering large benefits for patients with Hirschsprung disease with distended bowel after primary surgery.
AB - Purpose: Patients with Hirschsprung disease (HD) can have persistent obstructive symptoms after resection of the aganglionic segment. If obstructive symptoms are treated inadequately, this may lead to recurrent faecal stasis and impaction, and may result in severe distension of the bowel. A permanently distended bowel which not responds to conservative treatment may be an indication for redo surgery. The aim of this study is to describe our experiences and the short-term results of a novel technique: longitudinal antimesenteric resection with a longitudinal anastomosis. Methods: We reviewed the medical records of our three patients who underwent longitudinal resection of severe distended bowel. This technique aims to improve defecation by improving faecal passage and is characterized by resection of the antimesenteric side of the distended intestinal segment, followed by plication with a longitudinal anastomosis. In this paper, this novel technique is described in detail, as well as short-term outcomes. Results: All patients had an uneventful recovery after longitudinal antimesenteric resection. During follow-up, the functional outcomes were excellent, with a large improvement of bowel function. All patients were continent for faeces, and treated with low-dose laxatives or occasional preventive irrigation in one patient. There were no more complaints of persistent constipation or soiling. Conclusion: Longitudinal resection is a surgical redo-procedure offering large benefits for patients with Hirschsprung disease with distended bowel after primary surgery.
KW - Case report
KW - Hirschsprung disease
KW - Obstructive symptoms
KW - Re-operation
UR - http://www.scopus.com/inward/record.url?scp=85074610341&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85074610341&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31630213
U2 - https://doi.org/10.1007/s00384-019-03399-8
DO - https://doi.org/10.1007/s00384-019-03399-8
M3 - Article
C2 - 31630213
SN - 0179-1958
VL - 34
SP - 1983
EP - 1987
JO - International journal of colorectal disease
JF - International journal of colorectal disease
IS - 11
ER -