One-Stage Laparoscopic Pull-Through Operation Without Stoma for Total Colon Aganglionosis

Abstract

We describe a patient with total colon aganglionosis (TCA) who underwent a one-stage laparoscopic endorectal pull-through without stoma. We obtained a definitive diagnosis laparoscopically by intestinal seromuscular biopsy and appendectomy, after which a laparoscopic total colectomy was performed during the same operation. We divided the marginal vessels, proceeding proximally from the rectum, and performed an ileal-anal anastomosis according to the Soave method with use of a prolapsing technique. The postoperative course was uneventful, without diarrheal rushes or excessive loss of electrolytes. We believe that a one-stage laparoscopic pull-through without stoma is indicated in TCA, provided that the ileal aganglionic segment is relatively short.