Luaran klinis pada pasien dengan penyakit hirschprung paska tindakan transanal Swenson-like dan transanal Soave satu tahap

Nyoman Rudy Kurniawan Giri; Made  Darmajaya; I Gde Raka  Widiana

doi:10.15562/ism.v14i1.1693

Luaran klinis pada pasien dengan penyakit hirschprung paska tindakan transanal Swenson-like dan transanal Soave satu tahap

Nyoman Rudy Kurniawan Giri ,

Made Darmajaya ,

I Gde Raka Widiana ,

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DOI: https://doi.org/10.15562/ism.v14i1.1693 |
Published: 2023-04-04

Abstract

Introduction: Hirsprung's case surgery method is usually done through 3 stages. Since the three-step method greatly influences the incidence of postoperative enterocolitis and malnutrition, a single-stage surgery technique was developed. This technique is safe, cost-effective, and avoid stoma-related morbidity in infants. This study aimed to determine the difference in the clinical outcome between Swenson-like transanal and Soave 1 stage transanal procedures in patients with hirschsprung's disease.

Methods: This was a retrospective cohort study by taking secondary data from patient medical records from years 2017 to 2021. The total sample of 100 Hirschprung patients was divided into two groups; patients with transanal Swenson-like surgical techniques and Soave. Data were tabulated and statistically analyzed with descriptive and association analysis.

Results: There were differences in operating time based on the surgical technique used, with a median of 120.00 minutes in the 1st stage Swenson-like transanal technique group and 150.17 minutes in the transanal Soave group. The length of stay of patients with the Swenson-like surgical technique was shorter than the Soave technique (p <0.001). Postoperative complications of enterocolitis were less common with the Swenson-like technique than with the Soave technique.

Conclusion: There are differences in clinical outcomes in postoperative Hirschsprung patients with the Swenson-like and Soave 1 stage transanal technique..

Pendahuluan: Metode pembedahan kasus hirschsprung pada umumnya dilakukan melalui 3 tahap. Namun metode tiga tahap sangat berpengaruh terhadap kejadian enterokolitis dan malnutrisi paska pembedahan, sehingga dikembangkan pembedahan dengan teknik 1 tahap yang diketahui aman, cost-effective, dan menghindari morbiditas akibat stoma pada bayi. Penelitian ini bertujuan untuk mengetahui perbedaan luara klinis antara tindakan transanal Swenson-like dan transanal Soave 1 tahap pada pasien dengan penyakit Hirschsprung.

Metode: Penelitian ini merupakan penelitian retrospective cohort dengan mengambil data sekunder dari rekam medis pasien dari tahun 2017 sampai 2021. Total sampel sebanyak 100 pasien Hirschprung dibagi menajadi dua kelompok, yaitu teknik operasi transanal Swenson-like dan teknik operasi Soave. Data ditabulasi dan dianalisis statistik dengan menggunakan uji deskriptif dan asosiasi.

Hasil: Terdapat perbedaan lama waktu operasi berdasarkan teknik operasi yang digunakan, dengan median 120,00 menit pada kelompok teknik transanal Swenson-like 1 tahap dan 150,17 menit pada kelompok transanal Soave. Durasi lama rawat inap pasien teknik operasi Swenson-like lebih singkat dibandingkan teknik Soave (p < 0,001). Komplikasi enterokolitis paska bedah lebih jarang terjadi pada teknik operasi Swenson-like dibandingkan dengan Soave.

Simpulan: Terdapat perbedaan luara klinis pada pasien hirschsprung paska tindakan bedah dengan teknik transanal Swenson-like dan Soave 1 tahap.

References

Putu AI, Wayan DAI. Insidens dan karakteristik kelainan kongenital traktus gastrointestinal pada neonatus di Rumah Sakit Umum Pusat Sanglah Denpasar tahun 2015. Medicina. 2018;49(3):423-427.
Surya PAIIL, Dharmajaya IM. Symptoms and diagnosis of hirschsprung’s disease. E-Jurnal Medika Udayana. 2014;3(3):377-382.
Dickie BH, Webb KM, Eradi B, Levitt MA. The problematic Soave cuff in Hirschsprung disease: manifestations and treatment. J Pediatr Surg. 2014;49(1):77-80.
De La Torre L, Langer JC. Transanal endorectal pull-through for Hirschsprung disease: technique, controversies, pearls, pitfalls, and an organized approach to the management of postoperative obstructive symptoms. Semin Pediatr Surg. 2010;19(2):96-106.
Chatoorgoon K, Pena A, Lawal TA, Levitt M. The problematic Duhamel pouch in Hirschsprung's disease: manifestations and treatment. Eur J Pediatr Surg. 2011;21(6):366-9.
Ademuyiwa AO, Bode CO, Lawal OA, Seyi-Olajide J. Swenson's pull-through in older children and adults: peculiar peri-operative challenges of surgery. Int J Surg. 2011;9(8):652-654.
Langer JC, Durrant AC, de la Torre L, Teitelbaum DH, Minkes RK, Caty MG, dkk. One-stage transanal Soave pullthrough for Hirschsprung disease: a multicenter experience with 141 children. Ann Surg. 2003;238(4):569-583.
Singh R, Cameron BH, Walton JM, Farrokhyar F, Borenstein SH, Fitzgerald PG. Postoperative Hirschsprung's enterocolitis after minimally invasive Swenson's procedure. J Pediatr Surg. 2007;42(5):885-889.
Liem NT, Hau BD. One-stage operation for Hirschsprung's disease: experience with 192 cases. Asian J Surg. 2008;31(4):216-219.
Granéli C, Dahlin E, Börjesson A, Arnbjörnsson E, Stenström P. Diagnosis, symptoms, and outcomes of Hirschsprung's disease from the perspective of gender. Surg Res Pract. 2017;2017:9274940.
Mohajerzadeh L, Khaleghnejad Tabari A, Rouzrokh M, Mirshemirani AR, Sadeghian N, Ghoroubi J, dkk. Comparison between Swenson and Soave pull-through in Hirschprung Disease. Iranian Journal of Colorectal Research. 2015;3(4):1-4.
Gunadi, Luzman RA, Kencana SMS, Arthana BD, Ahmad F, Sulaksmono G, Rastaputra AS, Arini GP, Pitaka RT, Dwihantoro A, Makhmudi A. comparison of two different cut-off values of scoring system for diagnosis of Hirschsprung-associated enterocolitis after transanal endorectal pull-through. Front Pediatr. 2021;9:705663.
Bing X, Sun C, Wang Z, Su Y, Sun H, Wang L, dkk. Transanal pullthrough Soave and Swenson techniques for pediatric patients with Hirschsprung disease. Medicine (Baltimore). 2017;96(10):e6209.
Mahmud K, Khan A, Yasmeen BN, Islam M, Karim S. Classic Swenson abdomino perineal pull through in the treatment of Hirschsprung’s Disease - 3 years experience in a tertiary care Paediatric Hospital in Bangladesh. Northern International Medical College Journal. 2017;8(1):185–188.

[1] Putu AI, Wayan DAI. Insidens dan karakteristik kelainan kongenital traktus gastrointestinal pada neonatus di Rumah Sakit Umum Pusat Sanglah Denpasar tahun 2015. Medicina. 2018;49(3):423-427.

[2] Surya PAIIL, Dharmajaya IM. Symptoms and diagnosis of hirschsprung’s disease. E-Jurnal Medika Udayana. 2014;3(3):377-382.

[3] Dickie BH, Webb KM, Eradi B, Levitt MA. The problematic Soave cuff in Hirschsprung disease: manifestations and treatment. J Pediatr Surg. 2014;49(1):77-80.

[4] De La Torre L, Langer JC. Transanal endorectal pull-through for Hirschsprung disease: technique, controversies, pearls, pitfalls, and an organized approach to the management of postoperative obstructive symptoms. Semin Pediatr Surg. 2010;19(2):96-106.

[5] Chatoorgoon K, Pena A, Lawal TA, Levitt M. The problematic Duhamel pouch in Hirschsprung's disease: manifestations and treatment. Eur J Pediatr Surg. 2011;21(6):366-9.

[6] Ademuyiwa AO, Bode CO, Lawal OA, Seyi-Olajide J. Swenson's pull-through in older children and adults: peculiar peri-operative challenges of surgery. Int J Surg. 2011;9(8):652-654.

[7] Langer JC, Durrant AC, de la Torre L, Teitelbaum DH, Minkes RK, Caty MG, dkk. One-stage transanal Soave pullthrough for Hirschsprung disease: a multicenter experience with 141 children. Ann Surg. 2003;238(4):569-583.

[8] Singh R, Cameron BH, Walton JM, Farrokhyar F, Borenstein SH, Fitzgerald PG. Postoperative Hirschsprung's enterocolitis after minimally invasive Swenson's procedure. J Pediatr Surg. 2007;42(5):885-889.

[9] Liem NT, Hau BD. One-stage operation for Hirschsprung's disease: experience with 192 cases. Asian J Surg. 2008;31(4):216-219.

[10] Granéli C, Dahlin E, Börjesson A, Arnbjörnsson E, Stenström P. Diagnosis, symptoms, and outcomes of Hirschsprung's disease from the perspective of gender. Surg Res Pract. 2017;2017:9274940.

[11] Mohajerzadeh L, Khaleghnejad Tabari A, Rouzrokh M, Mirshemirani AR, Sadeghian N, Ghoroubi J, dkk. Comparison between Swenson and Soave pull-through in Hirschprung Disease. Iranian Journal of Colorectal Research. 2015;3(4):1-4.

[12] Gunadi, Luzman RA, Kencana SMS, Arthana BD, Ahmad F, Sulaksmono G, Rastaputra AS, Arini GP, Pitaka RT, Dwihantoro A, Makhmudi A. comparison of two different cut-off values of scoring system for diagnosis of Hirschsprung-associated enterocolitis after transanal endorectal pull-through. Front Pediatr. 2021;9:705663.

[13] Bing X, Sun C, Wang Z, Su Y, Sun H, Wang L, dkk. Transanal pullthrough Soave and Swenson techniques for pediatric patients with Hirschsprung disease. Medicine (Baltimore). 2017;96(10):e6209.

[14] Mahmud K, Khan A, Yasmeen BN, Islam M, Karim S. Classic Swenson abdomino perineal pull through in the treatment of Hirschsprung’s Disease - 3 years experience in a tertiary care Paediatric Hospital in Bangladesh. Northern International Medical College Journal. 2017;8(1):185–188.

Luaran klinis pada pasien dengan penyakit hirschprung paska tindakan transanal Swenson-like dan transanal Soave satu tahap

Abstract

References

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