TY - CHAP M1 - Book, Section TI - Hirschsprung Disease A1 - Teitelbaum, Daniel H. A1 - Wulkan, Mark L. A1 - Georgeson, Keith E. A1 - Langer, Jacob C. A2 - Ziegler, Moritz M. A2 - Azizkhan, Richard G. A2 - Allmen, Daniel von A2 - Weber, Thomas R. PY - 2014 T2 - Operative Pediatric Surgery, 2e AB - Diagnoses are typically made with suction rectal biopsy, however, when a full-thickness biopsy is needed, it is important to carefully determine your distance from the dentate line. This insures an accurate ruling in or out of Hirschsprung disease.A colostomy may be needed in those with severe enterocolitis or those with a delayed diagnosis and very dilated colon. In those cases, a laparoscopic inspection of the abdomen can often facilitate the identification of the transition zone, and placement of the initial incision (see later in chapter for laparoscopic leveling biopsies).The decision to perform an open versus laparoscopic-assisted or transanal pull-through probably does not affect the long-term results of the infant. Thus, the approach that the surgeon is most familiar with should be selected.For total colonic Hirschsprung disease either a standard Duhamel or endorectal pull-through is acceptable, and associated with similar outcomes. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1100434630 ER -