Long-Term Functional Outcomes and Multidisciplinary Management after Ileorectal Duhamel Pull-Through for Total Colonic Aganglionosis—20-Year Experience in a Tertiary Surgical Center
Topic overview
This 20-year retrospective study of 13 TCA patients after ileorectal Duhamel pull-through reveals significant long-term morbidity, with nearly half experiencing ongoing bowel continence issues requiring multidisciplinary management. While 11 patients achieved toilet training, only five are fully continent, and two required permanent stomas.
Key takeaways
- Total colonic aganglionosis represents 6.4% of Hirschsprung's cases and requires ileorectal Duhamel pull-through procedure.
- Only 45% of TCA patients achieve full continence after surgery; nearly half have ongoing bowel dysfunction requiring long-term management.
- Multidisciplinary team approach (surgery, gastroenterology, psychology, nursing) is essential for managing complex post-operative outcomes.
- Two patients (15%) required permanent stoma re-establishment due to persistent bowel management difficulties after pull-through.
- Median 13-year follow-up shows TCA carries significant long-term morbidity despite successful surgical intervention in neonatal period.
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How to cite: GlobalCastMD. Long-Term Functional Outcomes and Multidisciplinary Management after Ileorectal Duhamel Pull-Through for Total Colonic Aganglionosis—20-Year Experience in a Tertiary Surgical Center. GlobalCastMD Medical Library. 2023-12-12. https://dev.library.globalcastmd.com/article/8422?via_space=staycurrentmd
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