TACTICS OF SURGICAL TREATMENT FOR HIRSCHSPRUNG’S DISEASE IN YOUNG CHILDREN

Abstract

INTRODUCTION. Hirschsprung’s disease is one of the most common congenital disorders of the colon in children and requires mandatory surgical treatment. Despite significant progress in pediatric surgery, the problem of choosing the optimal surgical strategy and method of operative intervention remains relevant. The incidence of postoperative complications and functional disorders necessitates further improvement of surgical approaches.

MATERIALS AND METHODS. The study included 41 patients with rectal and rectosigmoid forms of Hirschsprung’s disease who were treated at the Department of Pediatric Surgery of the Multidisciplinary Children’s Clinic of Tashkent State Medical University during the period from 2020 to 2025. All children underwent transanal endorectal proctoplasty according to the De La Torre–Mondragón technique with resection of the aganglionic segment. Diagnosis was based on the analysis of complaints, medical history, clinical findings, and the results of radiographic, ultrasonographic, and laboratory investigations.

RESULTS AND DISCUSSION. Surgical intervention was predominantly performed in young children, which is associated with more favorable anatomical and functional conditions for transanal demucosation. In most cases, good and satisfactory functional outcomes were observed. The early postoperative period proceeded without severe complications. In the long-term follow-up, anastomotic stenosis was detected in 3 patients and was successfully managed using conservative methods.

CONCLUSION. Transanal endorectal proctoplasty according to the De La Torre–Mondragón method is an effective and safe surgical technique for the treatment of distal forms of Hirschsprung’s disease in children. This method reduces surgical trauma, accelerates rehabilitation, and improves functional outcomes, making it a preferred option in clinical practice.