Abstract Background Many options exist in the functional management of Hirschsprungs indisposition (HD). To gain insight into contemporary management, we queried pediatric surgeons listed in the American Pediatric Surgical Association Directory on their management for the rough-cut baby with HD. Methods Surveys were sent electronically to the surgeons concerning a typical newborn diagnosed with HD. Questions included the preferred advent, number of stages, anastomotic technique, length of goodish rectal cut, point of initiation of the anorectal dissection, and length of colonic resection. Surgeons performing laparoscopy were asked about how the colonic biopsy was performed. otherwise questions included the face of leveling colostomy, level of residents, and criteria for performing a primordial trans anal pull-through. The level best margin of open frame was calculated using a 95% confidence legal separation based on the response percentages for clear-cut variabl es. Results Surveys were sent to 719 surgeons with 270 responses. A minimally invasive approach is before presbyopic utilize by 80%, of which 42.3% favor laparoscopy and 37.7% prefer transanal dissection only. unless 5.4% of respondents prefer the Duhamel technique. A 1-stage approach is used by 85.6%. An fair muscular shock length of 2.4 cm (range, 0.5-6 cm) is promulgateed.
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A split muscular cuff is reported by 55%. On average, the anal inosculation is 0.73 cm (range, 0-4.5 cm) supra the top of the anal columns and 3.0 cm (0-12.5 cm) above the biopsy site on the ganglionic colon. Of the respondents using laparoscopy, 80.2% report using an intracorporeal colonic biopsy technique. Participation in a breeding program, eithe! r fellows and/or residents, is reported by 84.8% of respondents. The most common reason minded(p) for not performing a primary transanal pull-through is long segment disease (45.6%). Margin of error was no greater than 6% for any of the responses. Conclusions A minimally invasive approach with a 1-stage operation has become the...If you extremity to get a full essay, order it on our website:
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