Transanal pull-through procedure without stay sutures for Hirschsprung's disease: A retrospective case series study.

INTRODUCTION AND

IMPORTANCE

Hirschsprung disease (HD) is commonly managed by single-stage transanal pull-through (SS-TAPT). While effective, the classical technique involves time-consuming steps, including stay sutures for mucosal traction. We present a simplified SS-TAPT approach that omits stay sutures (sutureless traction technique), reducing operative time.

CASE PRESENTATION: A retrospective study of 26 infants (age 2-12 months) undergoing SS-TAPT without stay sutures at three hospitals (2022-2024). The transition zone was identified preoperatively (contrast enema) or intraoperatively in 17 cases.

CLINICAL DISCUSSION: Median operative time was 55 min (range: 50-80), with resected segments measuring 7-25 cm. All patients resumed oral feeding within 1-3 days. At a mean follow-up of 21 months, no complications (strictures, leaks) were observed.

CONCLUSIONS

Sutureless traction technique simplifies SS-TAPT, shortening operative time and maintaining safety. Long-term continence assessment is ongoing.