ArticleFrontiers in surgery2026
Developing expertise in laparoscopic management of total colonic aganglionosis cases: Duhamel vs. Swenson procedures.
Article in Frontiers in surgery, 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
Aim: To describe technical evolution of minimally invasive surgery (MIS) for total colonic aganglionosis (TCA) either Duhamel or Swenson procedures conducted by a single pediatric surgical team. Methods: 18 children with histologically proven TCA were managed between March 2018 and March 2022. All underwent laparoscopic definitive pull-through: Group A ( Results: Median age at definitive surgery was 3 years (range 18 months-5 years; mean ± SD = 3.0 ± 0.9 years). Median operative time was 4 h (range 3.5-5.5 h) for Group A and 5 h (range 4.5-6 h) for Group B. Median follow-up was 5 years (range 3-6 years). Early complications included two anastomotic stenoses (Group A) successfully treated with dilatation. No anastomotic leaks occurred. Median daily stool frequency at 6 months was 7 (range 5-10) in Group A vs. 5 (range 4-7) in Group B, improving to 3 (range 2-4) and 2 (range 1-3), respectively, by last follow-up. Fecal incontinence occurred in two patients (Group A). Three patients required loperamide and six cases used dietary fiber modification. Conclusion: Laparoscopic management of TCA is safe and feasible. Both Swenson-type and Duhamel approaches yield acceptable continence and growth outcomes, with the choice tailored to rectal anatomy and continence risk.
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