A decade of experience with the primary pull-through for Hirschsprung disease in the newborn period: A multicenter analysis of outcomes

Daniel H. Teitelbaum, Robert E. Cilley, Neil J. Sherman, David Bliss, Neal D. Uitvlugt, Elizabeth J. Renaud, Irfan Kirstioglu, Tamara Bengston, Arnold G. Coran

Research output: Contribution to journalArticle

124 Citations (Scopus)

Abstract

Objective: To determine whether use of a primary pull-through would result in equivalent perioperative and long-term complications compared with the two-stage approach. Summary Background Data: During the past decade, the authors have advanced the use of a primary pull-through for Hirschsprung disease in the newborn, and preliminary results have suggested excellent outcomes. Methods: From May 1989 through September 1999, 78 infants underwent a primary endorectal pull-through (ERPT) procedure at four pediatric surgical sites. Data were collected from medical records and a parental telephone interview (if the child was older than 3 years) to assess stooling patterns. A similar group of patients treated in a two-stage fashion served as a historical control. Results: Mean age at the time of ERPT was 17.8 days of life. Comparing primary ERPT with a two-stage approach showed a trend toward a higher incidence of enterocolitis in the primary ERPT group compared with those with a two-stage approach (42.0% vs. 22.0%). Other complications were either lower in the primary ERPT group or similar, including rate of soiling and development of a bowel obstruction. Median number of stools per day was two at a mean follow-up of 4.1 ± 2.5 years, with 83% having three or fewer stools per day. Conclusions: Performance of a primary ERPT for Hirschsprung disease in the newborn is an excellent option. Results were comparable to those of the two-stage procedure. The greater incidence of enterocolitis appears to be due to a lower threshold in diagnosing enterocolitis in more recent years.

Original languageEnglish (US)
Pages (from-to)372-380
Number of pages9
JournalAnnals of surgery
Volume232
Issue number3
DOIs
StatePublished - Sep 18 2000

Fingerprint

Enterocolitis
Hirschsprung Disease
Newborn Infant
Incidence
Medical Records
Interviews
Pediatrics

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Teitelbaum, Daniel H. ; Cilley, Robert E. ; Sherman, Neil J. ; Bliss, David ; Uitvlugt, Neal D. ; Renaud, Elizabeth J. ; Kirstioglu, Irfan ; Bengston, Tamara ; Coran, Arnold G. / A decade of experience with the primary pull-through for Hirschsprung disease in the newborn period : A multicenter analysis of outcomes. In: Annals of surgery. 2000 ; Vol. 232, No. 3. pp. 372-380.
@article{fe1403d63879480dbf971319323e64a3,
title = "A decade of experience with the primary pull-through for Hirschsprung disease in the newborn period: A multicenter analysis of outcomes",
abstract = "Objective: To determine whether use of a primary pull-through would result in equivalent perioperative and long-term complications compared with the two-stage approach. Summary Background Data: During the past decade, the authors have advanced the use of a primary pull-through for Hirschsprung disease in the newborn, and preliminary results have suggested excellent outcomes. Methods: From May 1989 through September 1999, 78 infants underwent a primary endorectal pull-through (ERPT) procedure at four pediatric surgical sites. Data were collected from medical records and a parental telephone interview (if the child was older than 3 years) to assess stooling patterns. A similar group of patients treated in a two-stage fashion served as a historical control. Results: Mean age at the time of ERPT was 17.8 days of life. Comparing primary ERPT with a two-stage approach showed a trend toward a higher incidence of enterocolitis in the primary ERPT group compared with those with a two-stage approach (42.0{\%} vs. 22.0{\%}). Other complications were either lower in the primary ERPT group or similar, including rate of soiling and development of a bowel obstruction. Median number of stools per day was two at a mean follow-up of 4.1 ± 2.5 years, with 83{\%} having three or fewer stools per day. Conclusions: Performance of a primary ERPT for Hirschsprung disease in the newborn is an excellent option. Results were comparable to those of the two-stage procedure. The greater incidence of enterocolitis appears to be due to a lower threshold in diagnosing enterocolitis in more recent years.",
author = "Teitelbaum, {Daniel H.} and Cilley, {Robert E.} and Sherman, {Neil J.} and David Bliss and Uitvlugt, {Neal D.} and Renaud, {Elizabeth J.} and Irfan Kirstioglu and Tamara Bengston and Coran, {Arnold G.}",
year = "2000",
month = "9",
day = "18",
doi = "10.1097/00000658-200009000-00009",
language = "English (US)",
volume = "232",
pages = "372--380",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

Teitelbaum, DH, Cilley, RE, Sherman, NJ, Bliss, D, Uitvlugt, ND, Renaud, EJ, Kirstioglu, I, Bengston, T & Coran, AG 2000, 'A decade of experience with the primary pull-through for Hirschsprung disease in the newborn period: A multicenter analysis of outcomes', Annals of surgery, vol. 232, no. 3, pp. 372-380. https://doi.org/10.1097/00000658-200009000-00009

A decade of experience with the primary pull-through for Hirschsprung disease in the newborn period : A multicenter analysis of outcomes. / Teitelbaum, Daniel H.; Cilley, Robert E.; Sherman, Neil J.; Bliss, David; Uitvlugt, Neal D.; Renaud, Elizabeth J.; Kirstioglu, Irfan; Bengston, Tamara; Coran, Arnold G.

In: Annals of surgery, Vol. 232, No. 3, 18.09.2000, p. 372-380.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A decade of experience with the primary pull-through for Hirschsprung disease in the newborn period

T2 - A multicenter analysis of outcomes

AU - Teitelbaum, Daniel H.

AU - Cilley, Robert E.

AU - Sherman, Neil J.

AU - Bliss, David

AU - Uitvlugt, Neal D.

AU - Renaud, Elizabeth J.

AU - Kirstioglu, Irfan

AU - Bengston, Tamara

AU - Coran, Arnold G.

PY - 2000/9/18

Y1 - 2000/9/18

N2 - Objective: To determine whether use of a primary pull-through would result in equivalent perioperative and long-term complications compared with the two-stage approach. Summary Background Data: During the past decade, the authors have advanced the use of a primary pull-through for Hirschsprung disease in the newborn, and preliminary results have suggested excellent outcomes. Methods: From May 1989 through September 1999, 78 infants underwent a primary endorectal pull-through (ERPT) procedure at four pediatric surgical sites. Data were collected from medical records and a parental telephone interview (if the child was older than 3 years) to assess stooling patterns. A similar group of patients treated in a two-stage fashion served as a historical control. Results: Mean age at the time of ERPT was 17.8 days of life. Comparing primary ERPT with a two-stage approach showed a trend toward a higher incidence of enterocolitis in the primary ERPT group compared with those with a two-stage approach (42.0% vs. 22.0%). Other complications were either lower in the primary ERPT group or similar, including rate of soiling and development of a bowel obstruction. Median number of stools per day was two at a mean follow-up of 4.1 ± 2.5 years, with 83% having three or fewer stools per day. Conclusions: Performance of a primary ERPT for Hirschsprung disease in the newborn is an excellent option. Results were comparable to those of the two-stage procedure. The greater incidence of enterocolitis appears to be due to a lower threshold in diagnosing enterocolitis in more recent years.

AB - Objective: To determine whether use of a primary pull-through would result in equivalent perioperative and long-term complications compared with the two-stage approach. Summary Background Data: During the past decade, the authors have advanced the use of a primary pull-through for Hirschsprung disease in the newborn, and preliminary results have suggested excellent outcomes. Methods: From May 1989 through September 1999, 78 infants underwent a primary endorectal pull-through (ERPT) procedure at four pediatric surgical sites. Data were collected from medical records and a parental telephone interview (if the child was older than 3 years) to assess stooling patterns. A similar group of patients treated in a two-stage fashion served as a historical control. Results: Mean age at the time of ERPT was 17.8 days of life. Comparing primary ERPT with a two-stage approach showed a trend toward a higher incidence of enterocolitis in the primary ERPT group compared with those with a two-stage approach (42.0% vs. 22.0%). Other complications were either lower in the primary ERPT group or similar, including rate of soiling and development of a bowel obstruction. Median number of stools per day was two at a mean follow-up of 4.1 ± 2.5 years, with 83% having three or fewer stools per day. Conclusions: Performance of a primary ERPT for Hirschsprung disease in the newborn is an excellent option. Results were comparable to those of the two-stage procedure. The greater incidence of enterocolitis appears to be due to a lower threshold in diagnosing enterocolitis in more recent years.

UR - http://www.scopus.com/inward/record.url?scp=0033848612&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033848612&partnerID=8YFLogxK

U2 - 10.1097/00000658-200009000-00009

DO - 10.1097/00000658-200009000-00009

M3 - Article

C2 - 10973387

AN - SCOPUS:0033848612

VL - 232

SP - 372

EP - 380

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 3

ER -