کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6217558 1273765 2013 10 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Transanal endorectal pull-through versus transabdominal approach for Hirschsprung's disease: A systematic review and meta-analysis
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پریناتولوژی (پزشکی مادر و جنین)، طب اطفال و بهداشت کودک
پیش نمایش صفحه اول مقاله
Transanal endorectal pull-through versus transabdominal approach for Hirschsprung's disease: A systematic review and meta-analysis
چکیده انگلیسی

AimTransanal endorectal pull-through (TERPT) has become popular for single-stage treatment of Hirschsprung's disease. The benefits of TERPT over the conventional transabdominal approach (TAB) are still unclear. We performed a comprehensive meta-analysis comparing the clinical outcomes of TERPT and TAB.MethodsOriginal articles published from 1998 to 2012 were searched from Medline, Embase, and Cochrane databases. Randomized controlled trials (RCT) and observational clinical studies (OCS) comparing TERPT and TAB were included. Outcomes evaluated included operative time, hospital stay and incidence of postoperative incontinence/soiling, constipation and enterocolitis. Pooled odds ratios (OR) were calculated for dichotomous variables; pooled mean differences (MD) were measured for continuous variables.ResultsOf 93 studies, 1 RCT and 11 OCS were included, comprising 444 cases of TERPT and 348 cases of TAB (215 Soave, 94 Duhamel, 24 Swenson, 15 Rehbein procedures). TERPT had shorter operative time (MD = − 57.85 min; 95% confidence interval [CI], − 83.11 to − 32.60; P < 0.00001) and hospital stay (MD = − 7.06 days; 95% CI, − 10.95 to − 3.16; P = 0.0004). TERPT had less postoperative incontinence/soiling (OR = 0.58; 95% CI 0.37-0.90; P = 0.01) and constipation (OR = 0.49; 95% CI 0.30-0.81; P = 0.005). There was no difference in incidence of postoperative enterocolitis.ConclusionTERPT is superior to TAB in operative time, hospital stay, postoperative incontinence and constipation. However, more randomized controlled trials are necessary to verify the benefit of TERPT for Hirschsprung's disease.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Pediatric Surgery - Volume 48, Issue 3, March 2013, Pages 642-651
نویسندگان
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