By: dr. Hardian Gunardi, SpB, SubspPed(K)
In a groundbreaking development, pediatric surgeons in Aceh are revolutionizing the treatment of Megacolon associated with Hirschsprung’s disease using an innovative one-step surgical technique called transanal endorectal pull-through. This technique is set to transform the landscape of pediatric surgery, offering significant benefits for young patients.
Hirschsprung’s disease, a congenital condition characterized by the absence of ganglion cells in the colon, has historically required multiple surgeries to alleviate the symptoms of Megacolon. However, dr. Muntadhar, SpB, SubspPed(K), a pediatric surgeon from Aceh have embraced the one-step approach as the new standard, streamlining the treatment process and enhancing patient outcomes. The procedure had been performed since 2017, with the average number of patients 60-80 patients per year.
The transanal endorectal pull-through procedure involves removing the aganglionic segment of the colon through the anus and pulling the healthy colon down to the anus in a single operation. This innovative technique eliminates the need for colostomy and significantly reduces the number of surgeries required, leading to improved recovery times, functional outcomes, and cosmetic outcomes. The surgery takes around 2 hours and leads to no visible scar.
The advantages of the one-step procedure are manifold. By eliminating the need for multiple surgeries, hospital stays have been drastically shortened, reducing healthcare costs and allowing children to return to their daily routines more swiftly. The average length of stay is around 3-5 days during this procedure. Additionally, the risk of complications, such as infections and anastomotic leakage, has significantly decreased, resulting in lower morbidity and mortality rates. Furthermore, the cosmesis of the procedure is noteworthy. The surgical scars remain hidden within the anal canal, addressing aesthetic concerns and boosting the self-confidence of young patients.
One of the most significant benefits of the transanal endorectal pull-through technique is the improved preservation of normal bowel function. By minimizing damage to the healthy colon, postoperative constipation and fecal incontinence, common concerns with the traditional staged approach, have been significantly reduced. This enhances the long-term quality of life for children living with Hirschsprung’s disease.
The outcome of this procedure in Aceh is considered excellent. Around 80% of the patient had a good and excellent in Klotz scoring in evaluation of the outcome of the procedure. The complete news could be watched via attached video.
