Minimal invasive surgery in total colonic aganglionosis

Aim of this study: To evaluate safety and efficacy of laparoscope in these cases. Methods: We had 9 cases of total colonic aganglionosis (TCA). A total colectomy was done in all cases. The average age to do an ileal pullthrough in ileostomized cases was one year; the closure of the ileostomy was performed after three years old, while in four nonileostomized cases was 2- 3 years old to do an operation. We separated these cases into two groups: Group A underwent direct ileoanal anastomosis with laparoscopic assistance for transanal pull-through, and Group B underwent laparoscopic Duhamel surgery. Results: We followed our cases 2 years postoperative, so we had two groups. In Group A, we found two cases of stenosis that respond to regular dilatation, one case of enterocolitis, two cases of faecal incontinence, three cases of perianal dermatitis, particularly in the first year after surgery, and electrolyte disturbance from frequent faecal incontinence. In contrast, Group B experienced three occurrences of enterocolitis, two episodes of constipation, in both groups, there was no anastomotic leak. Conclusion: Minimal invasive surgery is safe and have several advantages for cases of total colonic aganglionosis.