The purpose of this report is to evaluate the cost-effectiveness of a single-stage laparoscopic pull-through for Hirschsprung's disease compared to the traditional two-stage Duhamel procedure. In this series of 33 children, the length of hospitalization (2.5 ± 3.5 vs 10.6 ± 3.9, p<0.0 1), cost (19,088 ± 13,075 vs 34,110 ± 19,443, p<0.05), and complications were all significantly less with the laparoscopic assisted pull-through compared to the more traditional open approach.
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References
1.
1. Swenson O, Bill AH. Resection of rectum and rectosigmoid with preservation of the sphincter for benign spastic lesions producing megacolon. Surgery.1948; 24: 212-220.
2.
2. Swenson O, Sherman JO, Fisher SH. Diagnosis of congenital megacolon: an analysis of 501 patients. J Pediatr Surg.1973; 8: 587-594.
3.
3. Swenson O, Sherman JO, Fisher SH, et al. The treatment and postoperative complications of congenital megacolon: a 25-year follow-up. Ann Surg.1975; 182: 266-273.
4.
4. Duhamel B. A new operation for the treatment of Hirschsprung's disease. Arch Dis Child.1960; 35: 38-39.
5.
5. Smith BM, Steiner RB, and Lobe TE. Laparoscopic Duhamel pull-through procedure for Hirschsprung's disease in childhood. J Laparoendosc Surg.1994; 4: 273-276.
6.
6. Georgeson KE, Fuenfer MM, Hardin WD. Primary laparoscopic pullthrough for Hirschsprung's disease in infants and children. j Pediatr Surg.1995; 30: 1017-1021.
7.
7. Chen MK, Gross E, Bufo AJ, et al. Initial experience with laparoscopic assisted pull-through for Hirschsprung's disease. Pediatr Endosurg Innovative Techniques.1997; 1: 91-94.
8.
8. Kleinhaus S, Boley SJ, Sheran M, Sieber WK Hirschsprung's disease a survey of the Surgical Section of the American Academy of Pediatrics. J Pediatr Surg.1979;14:588-597.
9.
9. Carcassonne M, Morisson-Lacombe G, Letourneau JN. Primary corrective operation without decompression in infants less than three months of age with Hirschsprung's disease. J Pediatr Surg.1982; 17: 241-241.
10.
10. Carcassonne M, Guys JM, Morisson Lacombe G, Kreitman B. Management of Hirschsprung's disease: curative surgery before three months of age. J Pediatr Surg.1989; 24: 1032-1034.
12. Ghinelli C, Del Rossi C. Treatment of Hirschsprung's disease without colostomy. Pediatr Surg lnt.1993;8: 27-39.
13.
13. So HB, Schwartz DL, Becker JM, et al. Endorectal “pull-through” without preliminary colostomy in neonates with Hirschsprung's disease. J Pediatr Surg.1980; 15: 470-471.
14.
14. Cilley RE, Statter MB, Hirschl RB, et al. Definitive treatment of Hirschsprung's disease in the newborn with a one-stage procedure. Surgery. 1994;115:551-555.
15.
15. Langer JC, Fitzgerald PG, Winthrop AL, et al. One-stage versus two-stage Soave pull-through for Hirschsprung's disease in the first year of life.J Pediatr Surg.1996;31:33-37.
16.
16. Freeman RH, Burge DM, Soar JS, Sedgewick EM. The normal development of cortical evoked potentials in response to anal stimulation. ZKinderchir.1980; 31: 22-30.
17.
17. Bohm B, Milsom JW, Fazio VW. Postoperative intestinal motility following conventional and laparoscopic intestinal surgery. Arch Surg.1995; 130: 415-419.
18.
18. La Morte Al, Diamond MP. Adhesion formation after laparoscopy. Prog Clin Biol Res.1993; 381: 51-58.