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. 2025 May-Jun;30(3):330-342.
doi: 10.4103/jiaps.jiaps_279_24. Epub 2025 Apr 15.

Redo Pull-through in Hirschsprungs Disease - A Meta-Analysis of Outcomes Based on type of Pull-through

M Srinivasa Rao  1 , D Kalyan Ravi Prasad  2 , J Bhaskar Reddy  2
Affiliations

Redo Pull-through in Hirschsprungs Disease - A Meta-Analysis of Outcomes Based on type of Pull-through

M Srinivasa Rao et al. J Indian Assoc Pediatr Surg. 2025 May-Jun.

Abstract

Purpose: The meta-analysis investigates the effects of redo pull-through (PT) surgeries on bowel function outcomes in patients with rectosigmoid and long-segment Hirschsprung's disease (HD) who have already undergone an initial PT. By comparing different redo PT techniques, this study explores whether specific approaches yield better postoperative bowel function.

Methodology: A literature search was conducted for articles on redo PT for HD; this included PubMed and ScienceDirect databases. The search terms or MeSH words "Hirschsprung disease" OR "congenital megacolon" AND "re-do pull through" OR "re-do" OR "reoperation," connected by two Boolean operators "OR" and "AND," were used to search the databases for relevant articles.

Results: Fifteen articles of interest comprising 374 patients receiving redo PT were selected for analysis. The results suggest that selecting a redo PT method tailored to the patient's unique anatomical and surgical history may substantially improve functional outcomes, highlighting the potential for individualized strategies to enhance recovery and long-term quality of life for those requiring reoperation.

Conclusion: The findings indicate that the Swenson redo PT approach yielded better bowel function outcomes compared to other techniques. While redo PT procedures were effective in reducing fecal incontinence, the incidence of enterocolitis remained consistent across the various approaches.

Keywords: Duhamel; Hirschsprung’s disease; Soave; Swenson; endorectal pull-through; posterior sagittal; reoperation; transanal endorectal pull-through.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Forest plot comparing complications of redo Duhamel with Swenson. CI: Confidence interval
Figure 2
Figure 2
Forest plot comparing total complications of redo pull-through of Duhamel with Soave. CI: Confidence interval
Figure 3
Figure 3
Forest plot comparing total complications of redo pull-through of Swenson with Soave. CI: Confidence interval
Figure 4
Figure 4
Forest plot comparing total complications of overall primary with redo pull-through. CI: Confidence interval
Figure 5
Figure 5
Forest plot comparing continence between Duhamel and Swenson redo pull-through. CI: Confidence interval
Figure 6
Figure 6
Forest plot comparing continence between Duhamel and Soave redo pull-through. CI: Confidence interval
Figure 7
Figure 7
Forest plot comparing continence between Swenson and Soave redo pull-through. CI: Confidence interval
Figure 8
Figure 8
Forest plot comparing enterocolitis between Duhamel and Swenson redo pull-through. CI: Confidence interval
Figure 9
Figure 9
Forest plot comparing enterocolitis between Duhamel and Soave redo pull-through. CI: Confidence interval
See this image and copyright information in PMC

References

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