Outcomes of Hirschsprung Disease Patients After Transanal Swenson-like Pull-Through Surgery

Introduction: Transanal Swenson-like pull-through has been introduced as one of the definitive treatments for Hirschsprung disease (HSCR). However, the reports are still scarce and most of them are from developed countries. Our research objective was to determine the functional outcomes, Hirschsprung-associated enterocolitis (HAEC), and complications of children with HSCR after transanal Swenson-like pull-through and associate them with the prognostic factors, including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), nutritional status, and age at pull-through. Methods: A retrospective study was conducted for HSCR patients who underwent transanal Swenson-like pull-through in our hospital from 2017 to 2020. Krickenbeck classification was used to assess functional outcomes, including voluntary bowel movement (VBM), soiling, and constipation. At the same time, HAEC was evaluated using the HAEC scoring system with a cut-off level of � 4. Results: Thirteen HSCR patients underwent transanal Swenson-like pull-through at our institution. Only three patients were evaluated for functional outcomes since the other 10 subjects did not reach 3 years old when the study was performed: one patient with good VBM, two patients with grade 1 soiling, and one patient who complained of constipation. Among the 13 patients, seven experienced surgical site infections and three suffered from HAEC. There was no significant association between prognostic factors and postoperative complications. Conclusion: The outcomes of patients with HSCR after transanal Swenson-like pull-through in our institution are relatively considered good. Our report provides new evidence of the safety of transanal Swenson-like pull-through as definitive management for children with HSCR, particularly from a specific developing country.