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Comparative Study
. 2021 Jan 15;33(3):e1545.
doi: 10.1590/0102-672020200003e1545. eCollection 2021.

OBLIQUE VS. CIRCULAR ANASTOMOSIS IN THE CHILDREN UNDERWENT SOAVE'S PULL-THROUGH SURGERY FOR THE TREATMENT OF HIRSCHSPRUNG'S DISEASE: WHICH IS THE BEST?

[Article in English, Portuguese]
Shahnam Askarpour  1 , Mehran Peyvasteh  1 , Gholamreza Droodchi  1 , Hazhir Javaherizadeh  2
Affiliations
Comparative Study

OBLIQUE VS. CIRCULAR ANASTOMOSIS IN THE CHILDREN UNDERWENT SOAVE'S PULL-THROUGH SURGERY FOR THE TREATMENT OF HIRSCHSPRUNG'S DISEASE: WHICH IS THE BEST?

[Article in English, Portuguese]
Shahnam Askarpour et al. Arq Bras Cir Dig. .

Abstract
in English, Portuguese

Background: Oblique type of anastomosis. Several types of complications including constipation, fecal soiling, perianal excoriation, were reported among different types of surgery for Hirschsprung's disease.

Aim: To compare circular and oblique anastomoses following Soave's procedure for the treatment of Hirschsprung's disease.

Methods: Children who underwent Saove's pull through procedure with oblique and circular anastomoses were included. Duration of the follow up was two years after surgery. Postoperative complications, such as wound infection, wound dehiscence, peritonitis, fecal soiling, perianal excoriation, were recorded for each patient.

Results: Thirty-eight children underwent oblique anastomoses. Circular ones were done for 32 children. Perianal excoriation was seen in 57.89% and 46.87% of children in oblique and circular group, respectively. Enterocolitis was more frequent in circular (40.62%) than oblique (28.94%) group. Anastomotic stricture was more frequent in circular (15.62%) than oblique (7.89%).

Conclusion: Perianal excoriation was the most common complication among patient in both groups. Oblique anastomoses had fewer complications than circular, and may be appropriate option for patient who underwent Soave's procedure.

Racional:: Vários tipos de complicações, incluindo constipação, secreção fecal, escoriação perianal foram relatadas entre diferentes tipos de operações para a doença de Hirschsprung.

Objetivo:: Comparar as anastomoses circulares e oblíquas realizadas no procedimento de Soave para o tratamento da doença de Hirschsprung.

Métodos:: Neste estudo, foram incluídas crianças submetidas ao procedimento pull-through de Saove com anastomoses oblíquas e circulares. A duração do acompanhamento foi de dois anos no pós-operatório. Complicações, como infecção da ferida, deiscência da ferida, peritonite, secreção fecal, escoriação perianal foram registradas para cada paciente.

Resultados:: Trinta e oito crianças foram submetidas à anastomoses oblíquas. As circulares foram realizadas em 32. Escoriação perianal foi observada em 57,89% e 46,87% das crianças nos grupos oblíquo e circular, respectivamente. Enterocolite foi mais frequente no grupo circular (40,62%) do que oblíquo (28,94%). A estenose anastomótica foi mais frequente na circular (15,62%) do que na oblíqua (7,89%).

Conclusão:: A escoriação perianal foi a complicação mais comum entre os pacientes nos dois grupos. A anastomose oblíqua teve menos complicações do que a anastomose circular e pode ser a opção adequada para o paciente submetido ao procedimento de Soave.

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Conflict of interest statement

Conflict of interest: none

Figures

None
Oblique type of anastomosis
None
Anastomose oblíqua
FIGURE 1
FIGURE 1. Oblique type of anastomosis
See this image and copyright information in PMC

References

    1. Askarpour S, Peyvasteh M, Imanipour MH, Javaherizadeh H, Hesam S. Complications after transabdominal Soave’s procedure in children with Hirschsprung’s disease. Arq Bras Cir Dig. 2019;32(1):e1421. - PMC - PubMed
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