Totally transanal endorectal pull-through <i>versus</i> laparoscopic assistance endorectal pull-through in treatment of Hirschsprung’s disease: a meta-analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Yue ¹ , HUANG Ran ¹ , WU Wenyong ² , LI Tao ¹ ,  LI Weisong ¹

1. Department of Pediatric Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, P. R. China;
2. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, P. R. China;

Corresponding author：

LI Weisong, Email: 15955199807@126.com

Keywords：

Hirschsprung’s disease; children; transanal endorectal pull-through; laparoscope; meta-analysis

DOI：

10.7507/1007-9424.202006138

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the efficacy of totally transanal endorectal pull-through and laparoscopic assistance endorectal pull-through in the treatment of Hirschsprung’s disease (HD).Methods PubMed, EMBASE, The Cochrane Library, CNKI, Wanfang, and VIP Database were searched to screen out the comparative studies published between January 1998 and May 2020 on the treatment of HD with totally transanal endorectal pull-through and laparoscopic assistance endorectal pull-through. Then two reviewers independently completed the literatures screening, data extraction, and quality evaluation. The Review Manager 5.3 software was used to combine the effect size of the postoperative effect indicators included in the literatures. Stata 14.0 software was used to perform Begg’s and Egger’s tests on the publication bias of the included literatures.Results A total of 8 clinical studies conforming to the standards were included and 702 cases of children undergoing HD radical resection were recorded, including 335 cases in the totally transanal endorectal pull-through group and 367 cases in the laparoscopic assistance endorectal pull-through group. Compared with the laparoscopic assistance endorectal pull-through group, the totally transanal endorectal pull-through group had an advantage in the incidence of postoperative faecal incontinence/soiling [OR=0.20, 95%CI was (0.07, 0.54), P=0.001], and the postoperative constipation recurrence rate was higher than the laparoscopic assistance endorectal pull-through group [OR=2.39, 95%CI was (1.05, 5.42), P=0.04]. There were no statistically significant differences between the two groups in terms of postoperative enterocolitis [OR=1.01, 95%CI was (0.59, 1.75), P=0.96], postoperative adhesion intestinal obstruction [OR=0.74, 95%CI was (0.28, 1.95), P=0.54], and postoperative anastomotic stenosis [OR=1.14, 95%CI was (0.51, 2.56), P=0.74].Conclusions Compared with laparoscopic assistance endorectal pull-through, the totally transanal endorectal pull-through can reduce the incidence of postoperative faecal incontinence/soiling, but the rate of recurrence of postoperative constipation is higher. The two surgical procedures for HD have similar incidences of postoperative enterocolitis, anastomotic stenosis, and adhesive intestinal obstruction.

Citation： WANG Yue, HUANG Ran, WU Wenyong, LI Tao, LI Weisong. Totally transanal endorectal pull-through versus laparoscopic assistance endorectal pull-through in treatment of Hirschsprung’s disease: a meta-analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(4): 430-437. doi: 10.7507/1007-9424.202006138 Copy

1.	Thomson D, Allin B, Long AM, et al. Laparoscopic assistance for primary transanal pull-through in Hirschsprung’s disease: a systematic review and meta-analysis. BMJ Open, 2015, 5(3): e006063.
2.	King SK, Karpelowsky J. Hirschsprung disease. ANZ J Surg, 2017, 87(10): 754.
3.	Tian Y, Shi T, Wang F, et al. Difference of efficacy between laparoscopic modified Soave operation and open radical resection in the treatment of Hirschsprung’s disease. Pak J Med Sci, 2017, 33(6): 1385-1389.
4.	De la Torre-Mondragón L, Ortega-Salgado JA. Transanal endorectal pull-through for Hirschsprung’s disease. J Pediatr Surg, 1998, 33(8): 1283-1286.
5.	李龙. 我国小儿腔镜外科的现状和展望. 中华小儿外科杂志, 2016, 37(10): 721-723.
6.	Stang A, Jonas S, Poole C. Case study in major quotation errors: a critical commentary on the Newcastle-Ottawa scale. Eur J Epidemiol, 2018, 33(11): 1025-1031.
7.	Wells GA, Shea BJ, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomized studies in meta analysis. Appl Eng Agric, 2014, 18(6): 727-734.
8.	Seo S, Miyake H, Hock A, et al. Duhamel and transanal endorectal pull-throughs for Hirschsprung’ disease: a systematic review and meta-analysis. Eur J Pediatr Surg, 2018, 28(1): 81-88.
9.	Iacusso C, Leonelli L, Valfrè L, et al. Minimally invasive techniques for Hirschsprung disease. J Laparoendosc Adv Surg Tech A, 2019, 29(12): 1605-1608.
10.	Zheng Z, Zhang F, Jin Z, et al. Transanal endorectal stepwise gradient muscular cuff cutting pull-through method: technique refinements and comparison with laparoscopy-assisted procedures. Exp Ther Med, 2018, 16(3): 2144-2151.
11.	Guerra J, Wayne C, Musambe T, et al. Laparoscopic-assisted transanal pull-through (LATP) versus complete transanal pull-through (CTP) in the surgical management of Hirschsprung’s disease. J Pediatr Surg, 2016, 51(5): 770-774.
12.	van de Ven TJ, Sloots CE, Wijnen MH, et al. Transanal endorectal pull-through for classic segment Hirschsprung’s disease: with or without laparoscopic mobilization of the rectosigmoid? J Pediatr Surg, 2013, 48(9): 1914-1918.
13.	Dahal GR, Wang JX, Guo LH. Long-term outcome of children after single-stage transanal endorectal pull-through for Hirschsprung’s disease. World J Pediatr, 2011, 7(1): 65-69.
14.	Huang Y, Zheng S, Xiao X. A follow-up study on postoperative function after a transanal Soave 1-stage endorectal pull-through procedure for Hirschsprung’s disease. J Pediatr Surg, 2008, 43(9): 1691-1695.
15.	Ishikawa N, Kubota A, Kawahara H, et al. Transanal mucosectomy for endorectal pull-through in Hirschsprung’s disease: comparison of abdominal, extraanal and transanal approaches. Pediatr Surg Int, 2008, 24(10): 1127-1129.
16.	汤绍涛, 王国斌, 阮庆兰. 腹腔镜辅助技术在先天性巨结肠手术中的应用价值. 中华小儿外科杂志, 2007, 28(7): 347-350.
17.	吴雨昊, 辛良靖, 金鑫, 等. Sutureless手术与传统手术治疗完全性肺静脉异位引流疗效的Meta分析. 中华小儿外科杂志, 2019, 40(1): 15-22.
18.	Bradnock TJ, Knight M, Kenny S, et al. Hirschsprung’s disease in the UK and Ireland: incidence and anomalies. Arch Dis Child, 2017, 102(8): 722-727.
19.	Mille E, Dariel A, Louis-Borrione C, et al. Quality of life and neuropsychological development at school age in Hirschsprung’s disease. J Pediatr Surg, 2020, 55(8): 1481-1487.
20.	Mabula JB, Kayange NM, Manyama M, et al. Hirschsprung’s disease in children: a five year experience at a University teaching hospital in northwestern Tanzania. BMC Res Notes, 2014, 7: 410.
21.	冯杰雄, 焦春雷. 先天性巨结肠微创治疗. 中华实用儿科临床杂志, 2014, 29(23): 1768-1771.
22.	Nakamura M, Wada M, Fukuzawa T, et al. Treatment of classic-type Hirschsprung’s disease: rectoplasty with posterior triangular colonic flap versus transanal endorectal pull-through with rectoanal myotomy. Pediatr Surg Int, 2019, 35(2): 203-207.
23.	Townley OG, Lindley RM, Cohen MC, et al. Functional outcome, quality of life, and ‘failures’ following pull-through surgery for Hirschsprung’s disease: a review of practice at a single-center. J Pediatr Surg, 2020, 55(2): 273-277.
24.	Meinds RJ, van der Steeg AFW, Sloots CEJ, et al. Long-term functional outcomes and quality of life in patients with Hirschsprung’s disease. Br J Surg, 2019, 106(4): 499-507.
25.	Rintala RJ, Pakarinen MP. Long-term outcomes of Hirschsprung’s disease. Semin Pediatr Surg, 2012, 21(4): 336-343.
26.	Menezes M, Corbally M, Puri P. Long-term results of bowel function after treatment for Hirschsprung’s disease: a 29-year review. Pediatr Surg Int, 2006, 22(12): 987-990.
27.	Tomuschat C, Virbel CR, O’Donnell AM, et al. Reduced expression of the NLRP6 inflammasome in the colon of patients with Hirschsprung’s disease. J Pediatr Surg, 2019, 54(8): 1573-1577.
28.	Soh HJ, Nataraja RM, Pacilli M. Prevention and management of recurrent postoperative Hirschsprung’s disease obstructive symptoms and enterocolitis: systematic review and meta-analysis. J Pediatr Surg, 2018, 53(12): 2423-2429.
29.	Nakamura H, Lim T, Puri P. Inflammatory bowel disease in patients with Hirschsprung’s disease: a systematic review and meta-analysis. Pediatr Surg Int, 2018, 34(2): 149-154.

1. Thomson D, Allin B, Long AM, et al. Laparoscopic assistance for primary transanal pull-through in Hirschsprung’s disease: a systematic review and meta-analysis. BMJ Open, 2015, 5(3): e006063.
2. King SK, Karpelowsky J. Hirschsprung disease. ANZ J Surg, 2017, 87(10): 754.
3. Tian Y, Shi T, Wang F, et al. Difference of efficacy between laparoscopic modified Soave operation and open radical resection in the treatment of Hirschsprung’s disease. Pak J Med Sci, 2017, 33(6): 1385-1389.
4. De la Torre-Mondragón L, Ortega-Salgado JA. Transanal endorectal pull-through for Hirschsprung’s disease. J Pediatr Surg, 1998, 33(8): 1283-1286.
5. 李龙. 我国小儿腔镜外科的现状和展望. 中华小儿外科杂志, 2016, 37(10): 721-723.
6. Stang A, Jonas S, Poole C. Case study in major quotation errors: a critical commentary on the Newcastle-Ottawa scale. Eur J Epidemiol, 2018, 33(11): 1025-1031.
7. Wells GA, Shea BJ, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of non-randomized studies in meta analysis. Appl Eng Agric, 2014, 18(6): 727-734.
8. Seo S, Miyake H, Hock A, et al. Duhamel and transanal endorectal pull-throughs for Hirschsprung’ disease: a systematic review and meta-analysis. Eur J Pediatr Surg, 2018, 28(1): 81-88.
9. Iacusso C, Leonelli L, Valfrè L, et al. Minimally invasive techniques for Hirschsprung disease. J Laparoendosc Adv Surg Tech A, 2019, 29(12): 1605-1608.
10. Zheng Z, Zhang F, Jin Z, et al. Transanal endorectal stepwise gradient muscular cuff cutting pull-through method: technique refinements and comparison with laparoscopy-assisted procedures. Exp Ther Med, 2018, 16(3): 2144-2151.
11. Guerra J, Wayne C, Musambe T, et al. Laparoscopic-assisted transanal pull-through (LATP) versus complete transanal pull-through (CTP) in the surgical management of Hirschsprung’s disease. J Pediatr Surg, 2016, 51(5): 770-774.
12. van de Ven TJ, Sloots CE, Wijnen MH, et al. Transanal endorectal pull-through for classic segment Hirschsprung’s disease: with or without laparoscopic mobilization of the rectosigmoid? J Pediatr Surg, 2013, 48(9): 1914-1918.
13. Dahal GR, Wang JX, Guo LH. Long-term outcome of children after single-stage transanal endorectal pull-through for Hirschsprung’s disease. World J Pediatr, 2011, 7(1): 65-69.
14. Huang Y, Zheng S, Xiao X. A follow-up study on postoperative function after a transanal Soave 1-stage endorectal pull-through procedure for Hirschsprung’s disease. J Pediatr Surg, 2008, 43(9): 1691-1695.
15. Ishikawa N, Kubota A, Kawahara H, et al. Transanal mucosectomy for endorectal pull-through in Hirschsprung’s disease: comparison of abdominal, extraanal and transanal approaches. Pediatr Surg Int, 2008, 24(10): 1127-1129.
16. 汤绍涛, 王国斌, 阮庆兰. 腹腔镜辅助技术在先天性巨结肠手术中的应用价值. 中华小儿外科杂志, 2007, 28(7): 347-350.
17. 吴雨昊, 辛良靖, 金鑫, 等. Sutureless手术与传统手术治疗完全性肺静脉异位引流疗效的Meta分析. 中华小儿外科杂志, 2019, 40(1): 15-22.
18. Bradnock TJ, Knight M, Kenny S, et al. Hirschsprung’s disease in the UK and Ireland: incidence and anomalies. Arch Dis Child, 2017, 102(8): 722-727.
19. Mille E, Dariel A, Louis-Borrione C, et al. Quality of life and neuropsychological development at school age in Hirschsprung’s disease. J Pediatr Surg, 2020, 55(8): 1481-1487.
20. Mabula JB, Kayange NM, Manyama M, et al. Hirschsprung’s disease in children: a five year experience at a University teaching hospital in northwestern Tanzania. BMC Res Notes, 2014, 7: 410.
21. 冯杰雄, 焦春雷. 先天性巨结肠微创治疗. 中华实用儿科临床杂志, 2014, 29(23): 1768-1771.
22. Nakamura M, Wada M, Fukuzawa T, et al. Treatment of classic-type Hirschsprung’s disease: rectoplasty with posterior triangular colonic flap versus transanal endorectal pull-through with rectoanal myotomy. Pediatr Surg Int, 2019, 35(2): 203-207.
23. Townley OG, Lindley RM, Cohen MC, et al. Functional outcome, quality of life, and ‘failures’ following pull-through surgery for Hirschsprung’s disease: a review of practice at a single-center. J Pediatr Surg, 2020, 55(2): 273-277.
24. Meinds RJ, van der Steeg AFW, Sloots CEJ, et al. Long-term functional outcomes and quality of life in patients with Hirschsprung’s disease. Br J Surg, 2019, 106(4): 499-507.
25. Rintala RJ, Pakarinen MP. Long-term outcomes of Hirschsprung’s disease. Semin Pediatr Surg, 2012, 21(4): 336-343.
26. Menezes M, Corbally M, Puri P. Long-term results of bowel function after treatment for Hirschsprung’s disease: a 29-year review. Pediatr Surg Int, 2006, 22(12): 987-990.
27. Tomuschat C, Virbel CR, O’Donnell AM, et al. Reduced expression of the NLRP6 inflammasome in the colon of patients with Hirschsprung’s disease. J Pediatr Surg, 2019, 54(8): 1573-1577.
28. Soh HJ, Nataraja RM, Pacilli M. Prevention and management of recurrent postoperative Hirschsprung’s disease obstructive symptoms and enterocolitis: systematic review and meta-analysis. J Pediatr Surg, 2018, 53(12): 2423-2429.
29. Nakamura H, Lim T, Puri P. Inflammatory bowel disease in patients with Hirschsprung’s disease: a systematic review and meta-analysis. Pediatr Surg Int, 2018, 34(2): 149-154.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Totally transanal endorectal pull-through versus laparoscopic assistance endorectal pull-through in treatment of Hirschsprung’s disease: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content