{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:11:44Z","timestamp":1785449504155,"version":"3.56.0"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction Hirschsprung\u2019s disease (HSCR) is congenital aganglionosis affecting the hindgut and presents with constipation. Surgical pull-through is the current standard treatment but causes morbidity. Per-rectal endoscopic myotomy is a novel third-space endoscopy technique for treating short-segment (SS)-HSCR.<\/jats:p><jats:p>\n          Methods Retrospective study of SS-HSCR patients diagnosed on history, contrast enema, rectal biopsies, and anorectal manometry, and treated by PREM. The aganglionic segment was mapped before PREM was performed using third-space endoscopy principles. Stool frequency and laxative usage before and after PREM were compared.<\/jats:p><jats:p>\n          Results Nine patients (age 7.5 [\u00b1\u200a5.2] years; 7 male) underwent PREM during a 4-year period. Mean aganglionic segment length was 6.3\u200acm, mean procedure time 96.1 minutes, and mean length of hospital stay 2.5 days. Median follow-up was 17 months (range 9\u201358 months). Stool frequency was 1\/4.4 days before vs. 1\/1.2 days after PREM (P\u200a=\u200a0.0004). Mean laxative usage was 5.4 units of laxative (UL) before vs. 0.4 UL after PREM (P\u200a=\u200a0.0002). No laxatives were used by 6\/9 patients after PREM. The single adverse effect seen (anal stenosis) was treated with dilatation. <\/jats:p><jats:p>\n          Conclusions PREM is a safe and effective minimally invasive procedure to treat SS-HSCR and results in long-term response.<\/jats:p>","DOI":"10.1055\/a-1332-6902","type":"journal-article","created":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T03:18:36Z","timestamp":1607483916000},"page":"1256-1260","source":"Crossref","is-referenced-by-count":18,"title":["Initial experience with per-rectal endoscopic myotomy for Hirschsprung\u2019s disease: medium and long term outcomes of the first case series of a novel third-space endoscopy procedure"],"prefix":"10.1055","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7632-814X","authenticated-orcid":false,"given":"Amol","family":"Bapaye","sequence":"additional","affiliation":[{"name":"Shivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parag","family":"Dashatwar","sequence":"additional","affiliation":[{"name":"Shivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishnu","family":"Biradar","sequence":"additional","affiliation":[{"name":"Shivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shital","family":"Biradar","sequence":"additional","affiliation":[{"name":"Department of Pathology, Deenanath Mangeshkar Hospital and Research Center, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajendra","family":"Pujari","sequence":"additional","affiliation":[{"name":"Shivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"ref1","first-page":"1565","article-title":"Motility disorders and Hirschsprung disease","volume":"2008","author":"R Wyllie","journal-title":"In: Kliegman R, Behrman R, Jenson H, Stanton B, eds. Nelson textbook of pediatrics. 18th edn. Philadelphia, PA: Saunders Elsevier"},{"key":"ref2","first-page":"400","article-title":"Diagnosis and treatment of Hirschsprung\u2019s disease in Japan","volume":"199","author":"K Ikeda","year":"1984","journal-title":"An analysis of 1628 patients. Ann Surg"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1053\/jpsu.2002.31625","article-title":"Long term outcome and quality of life after Swenson procedure for Hirschsprung\u2019s disease","volume":"37","author":"Y Bai","year":"2002","journal-title":"J Pediatr Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s00383-007-2089-1","article-title":"Hirschsprung\u2019s disease: 13 years\u2019 experience in 112 patients from a single institution","volume":"24","author":"Prato A Pini","year":"2008","journal-title":"Pediatr Surg Int"},{"key":"ref5","first-page":"383","article-title":"Early and late complications following pull-through operation for Hirschsprung\u2019s disease","volume":"2019","author":"R M Rentea","journal-title":"In: Puri P, ed. Hirschsprung\u2019s disease and allied disorders. 4th edn. Springer International"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1001\/archsurg.1975.01360140135026","article-title":"Rectal myectomy in Hirschsprung disease: a decade of experience","volume":"110","author":"H B Lynn","year":"1975","journal-title":"Arch Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1001\/archsurg.1994.01420330034008","article-title":"Limited surgery for lower-segment Hirschsprung\u2019s disease","volume":"129","author":"R Sawin","year":"1994","journal-title":"Arch Surg"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1097\/00000658-197005000-00020","article-title":"Posterior sphincterotomy and rectal myotomy in the management of Hirschsprung\u2019s disease","volume":"171","author":"C G Thomas Jr.","year":"1970","journal-title":"Ann Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1111\/den.12689","article-title":"Per rectal endoscopic myotomy for the treatment of adult Hirschsprung\u2019s disease: first human case (with video)","volume":"28","author":"A Bapaye","year":"2016","journal-title":"Dig Endosc"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"E644","DOI":"10.1055\/a-0583-7570","article-title":"Per-rectal endoscopic myotomy (PREM) for pediatric Hirschsprung\u2019s disease","volume":"50","author":"A Bapaye","year":"2018","journal-title":"Endoscopy"},{"key":"ref11","first-page":"OP209V","article-title":"Per rectal endoscopic myotomy (PREM) for infantile Hirschsprung\u2019s disease","volume":"50","author":"A Bapaye","year":"2018","journal-title":"Endoscopy"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.vgie.2018.02.008","article-title":"A novel endoscopic technique to obtain rectal biopsy specimens in children with suspected Hirschsprung\u2019s disease","volume":"3","author":"Z Nabi","year":"2018","journal-title":"VideoGIE"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1136\/gut.2009.200444","article-title":"The London classification of gastrointestinal neuromuscular pathology: report on behalf of the Gastro 2009 International Working Group","volume":"59","author":"C H Knowles","year":"2010","journal-title":"Gut"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"e12939","DOI":"10.1111\/nmo.12939","article-title":"Morphometric profile of large intestinal neuronal plexuses in normal perinatal autopsies and Hirschsprung disease","volume":"29","author":"H Subramanian","year":"2017","journal-title":"Neurogastroenterol Motil"},{"key":"ref15","first-page":"255","volume-title":"Intestinal motor disorders","author":"R P Kapur","year":"2014"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1007\/s100249900167","article-title":"Diagnosis of Hirschsprung disease using the rectal biopsy: multi-institutional survey","volume":"2","author":"S J Qualman","year":"1999","journal-title":"Pediatr Dev Pathol"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.gie.2009.10.027","article-title":"A lexicon for endoscopic adverse events: report of an ASGE workshop","volume":"71","author":"P B Cotton","year":"2010","journal-title":"Gastrointest Endosc"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"AB451","DOI":"10.1016\/j.gie.2013.03.376","article-title":"Mo1628 A new potential method per anus endoscopic myotomy for treatment of internal anal sphincter achalasia","volume":"77","author":"L Wang","year":"2013","journal-title":"Gastrointest Endosc"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"S1501","DOI":"10.1016\/S0016-5085(19)40832-9","article-title":"Tu1690 Per rectal endoscopic myotomy for Hirshprung\u2019s disease in rescue of unsuccessful previous surgical myomectomy","volume":"156","author":"D J Bandres","year":"2019","journal-title":"Gastroenterology"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1332-6902.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T09:51:26Z","timestamp":1660125086000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1332-6902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,8]]},"references-count":19,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,11,24]]},"published-print":{"date-parts":[[2021,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1332-6902","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,12,8]]},"published":{"date-parts":[[2020,12,8]]}}}