ArticlePediatric surgery international2026
Long-term outcomes of transanal endorectal pull-through for Hirschsprung disease: the role of a dedicated surgical team and structured follow-up in a 17-year cohort.
Article in Pediatric surgery international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe transanal endorectal pull-through (TEPT) procedure has become the preferred technique for Hirschsprung disease (HD). Long-term functional outcomes beyond five years remain underreported, particularly from Middle Eastern centers. This study evaluated surgical and long-term functional outcomes of TEPT at a single tertiary center over 17 years, with emphasis on surgical expertise and structured follow-up. MATERIALS AND
methodsPatients with HD who underwent TEPT between January 2005 and December 2021 were retrospectively reviewed. More than 90% of procedures were performed and followed up by the same surgical team, consisting of pediatric surgeons specializing in colorectal surgery. Short-term outcomes and long-term functional outcomes including enterocolitis, anal stricture, constipation, and soiling were analyzed.
resultsNinety-one patients underwent TEPT; 75 (82.4%) were male. Median age at surgery was 5.3 months (range: 1.1-137 months). Short-segment disease was present in 77 patients (84.6%) and long-segment disease in 14 (15.4%). Single-stage TEPT was performed in 61 patients (67%). No perioperative complications occurred. Median hospital stay was 4.7 days. At a mean follow-up of 5.57 ± 3.74 years, enterocolitis occurred in 7 patients (7.7%), anal stricture in 16 (17.6%), constipation in 16 (17.6%), and soiling in 12 (13.2%), all of which resolved with conservative management except persistent soiling in 3 patients (3.3%). Long-segment disease showed numerically higher complication rates without reaching statistical significance.
conclusionIn this cohort, TEPT was associated with no perioperative complications and a 7.7% enterocolitis rate markedly lower than many published series. The principal long-term functional complications were largely transient and resolved with conservative management. These outcomes were achieved with a standardized operative technique and a structured, surgeon-led follow-up protocol enabling early detection and treatment of complications. These findings suggest that HD care may be best concentrated in experienced, specialized pediatric surgical centers.
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