Research Article

Comparison of the Results of Transanal Endorectal Pull-through and Martin-modified Duhamel Operations in Hirschsprung Disease


  • Yasemin Dere Günal
  • Mustafa Kemal Aslan
  • Ayşe Karaman
  • İbrahim Karaman
  • Derya Erdoğan
  • Yusuf Hakan Çavuşoğlu

Received Date: 25.10.2019 Accepted Date: 31.10.2019 J Ankara Univ Fac Med 2019;72(3):349-355


We compared the results of patients who underwent transanal endorectal pull-through (TEPT) and Martin-modified Duhamel operations for Hirschsprung’s disease (HD).

Materials and Methods:

Between 2002 and 2007, we evaluated 53 patients with HD treated with TEPT (group 1, n=24), endorectal pull-through with a laparotomy requirement after an initiated transanal approach (group 2, n=12) and Martin-modified Duhamel (group 3, n=17). Age, gender, length of aganglionic segment, intraoperative details, postoperative early complications and long term functional outcomes are evaluated and compared among these patient groups.


In this study age at the time of the operation, duration of the operation, time to first oral feeding, time to first stool and hospital stay in the patients the group 1 were significantly less or shorter than those ones in group 2 and group 3 (p<0.001). Blood transfusion requirement during operation in group 1 was less than the other groups, but this difference didn’t reach statistical significance (p>0.05). Postoperative enterocolitis had a higher incidence in group 3, but there was also no significant difference (p>0.05). There was no difference in the long-term functional results (continence, fecal soiling, constipation) of all three procedures (p>0.05).


TEPT is both a feasible and safe technique. It may be the first choice particularly in patients with early diagnosed rectosigmoid HD patients without enterocolitis or bowel dilatation.

Keywords: Transanal Endorectal Pull-through, Hirshsprung’s Disease, Duhamel Pull-through

Full Text (Turkish)