Objective: Hirschsprung’s disease is one of the common causes of obstruction in children. Transanal endorectal pull-through represents the latest development in the concept of the minimally invasive surgery for Hirschsprung’s disease. In this study, we present our early experience with single stage transanal pull through in children diagnosed with Hirschprung’s Disease on radioimaging.

Design: Retrospective study of children with single stage transanal pull-through done for Hirschsprung’s disease in our institute from Oct 2013 to January 2016.

Material and Method: 12 boys with age remaining 1 month to 2 years who presented with Hirschsprung’s disease were studied. The selection criteria included radiological transition zone at rectosigmoid , no evidence of enterocolitis or sepsis and no associated major anomaly. Pre-operative bowel preparation was done using warm saline until effective decompression of the bowel was achieved .Single stage transanal endorectal pull-through was done in these patients. The follow-up period ranged from 6 months to 2 years.

Results: 12 male patients with a mean age of 8.7 months (range 1 month to 2 years) underwent transanal endorectal pull through. The mean operating time was 73 min (range 60 to 120 min). The average length of bowel resected was 15.5 cm (range – 10 to 18 cm). Post-operatively patients passed first stool between 2nd and 3rd day. Oral feeding was resumed on 5th to 6th post-operative day. The average post-operative duration of stay in hospital was 10 days.The first rectal examintion was performed under anaesthesia three weeks after the operation for the assessment of anastomotic site for any stricture, stenosis or any pus discharge. There after patients were followed up every 15 days for 3 months and assessed for pattern of stooling, enterocolitis and weight gain. After 3 months follow up was done at monthly interval. No mortality occurred in the series.

Conclusion: Advancement in pediatric anaesthesia, availability of pediatric surgical expertise, improvement in preoperative and post-operative management and nursing care has made single stage transanal pullthrough in children a feasible option. The early results are comparable to single stage or multistage surgery in older children.