Evidence map›Paper›PMID 38976010›Full record

ReviewPediatric surgery international2024

Surgical maneuvers for long-segment Hirschsprung pull-through in unique patients.

M Zornoza, L Muñoz, A Ruiz, L De la Torre

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In one paragraph

Review in Pediatric surgery international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

M ZornozaCirugía Pediátrica Colorrectal, Centro Colorrectal Para Niños, Hospital Ángeles Puebla, Puebla, México. mariazornoza@gmail.com.
L MuñozCirugía Pediátrica, Hospital del Carmen de Maipú, Santiago de Chile, Chile.
A RuizCirugía Pediátrica Colorrectal, Centro Colorrectal Para Niños, Hospital Ángeles Puebla, Puebla, México.
L De la TorreInternational Center for Colorectal Urogenital Care, Department of Surgery, Division of Pediatric Surgery, Children's Hospital Colorado, Denver, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePatients with Hirschsprung disease affecting the splenic flexure or more proximal segments present a surgical challenge. Mobilizing the transverse colon to the pelvis during a pull-through may obstruct the distal ileum, or the length may be insufficient to reach the lower pelvis. This retrospective study aimed to describe two surgical techniques that facilitate mobilization of the transverse colon and their outcome.

methodsWe included patients operated on between April 2017 and April 2024 and analyzed sex, comorbidities, type of pull- through, age at pull-through, history of previous surgeries, cause of the proximal transverse colon pull-through, technique used (Deloyers or Turnbull), complications , postoperative outcome and follow-up. The first technique used was the maneuver described by Turnbull. This operation creates a mesenteric defect and mobilizes the colon into this mesenteric window at the distal ileum level. The second technique was described by Deloyers and involves a 180-degree rotation of the right colon by dissecting the right colon attachment and the hepatocolic ligament. The cecum and the ileocecal valve are placed in the right upper quadrant, and the distal colon is mobilized into the pelvis.

resultsWe included 13 patients, 12 boys and 1 girl. Eight patients had previous surgeries in another hospital: five had an initial transverse colostomy, and three had an ileostomy. The remaining five had the initial operation in our hospital: two had an ileostomy, two had a colostomy, and one had a primary pull-through. The median age at pull-through was 16 months (4-59 months). We used the Turnbull technique in four patients whose aganglionosis was limited to the middle transverse colon. The Deloyers technique was used in the remaining patients, with ganglion cells in the proximal transverse colon. We left a protective ileostomy in five patients. The median follow-up was 4.5 years (3 months to 10 years). The stoma takedown is pending in one patient.

conclusionThe Turnbull and Deloyers techniques were helpful in patients with aganglionosis affecting the transverse colon.

Indexed as

Hirschsprung DiseaseChild, PreschoolColon, TransverseDigestive System Surgical ProceduresFemaleHumansInfantMalePostoperative ComplicationsRetrospective StudiesTreatment OutcomeAganglionosisColonic rotationHirschsprungLong-segment

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.