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To share our experience in the surgical management of patients with Hirschsprung disease (HD) using the trans-anal endorectal pull-through “Soave” technique.
The trans-anal endorectal pull-through provides an effective surgical treatment for Hirschsprung disease. The high prevalence of fecal soiling after surgery highlights the importance of long-term follow-up to provide the required support for these patients during adolescence and transition into adulthood.
The disease is named after Harald Hirschsprung who early reported on a case of constipation due to dilatation and hypertrophy of the colon in 1886 []. In 1948, Orvar Swenson described the narrowing of the distal colon (absent peristalsis) and suggested that removal of this colonic segment would provide a surgical cure for HD []; the disease then became of great interest to pediatric surgeons all over the world. Franco Soave (1964) introduced the idea of endorectal pull-through by dissecting the surgical plane between the mucosa and the muscle of the rectum in order to protect the nearby pelvic nerves and genitourinary structures []. Later in 1998, Luis de la Torre modified Soave’s procedure by performing a single-stage trans-anal endorectal pull-through [].
