{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T13:56:58Z","timestamp":1772632618141,"version":"3.50.1"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"\n Aim of the study<\/jats:title>\n To evaluate the use of staged vs. one-stage surgical management for Hirschsprung's disease (HSD) in older children.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In total, 30 patients were diagnosed with HSD and all cases were confirmed by rectal biopsy. For treatment, rectal irrigation was carried out for two months to achieve colonic decompression; treatment failure occurred in 15 cases due to decompressed colons. In these cases, colostomy or ileostomy were carried out according to the distal or proximal site of the transitional zone to the transverse colon. After two months, eight cases of Laparoscopic Duhamel and seven cases of laparoscopic-aided Swenson were performed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n An anal dilation program was done three weeks after pull-through. Postoperatively, there were three cases of Swenson cases stenosis and two cases of enterocolitis that responded to conservative treatment and one case of fecal incontinence. In Duhamel cases, we had three cases of constipation and three cases of enterocolitis, with no anastomotic leak cases. Four cases of stomal prolapse and skin excoriation occurred.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Both staged and single-staged procedures are safe options for the management of hirshspung's disease in older children.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1773691","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:02:45Z","timestamp":1772607765000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical decision making in late-presenting Hirschsprung's disease: direct pull-though or stoma first"],"prefix":"10.3389","volume":"13","author":[{"given":"Ahmed","family":"Arafa","sequence":"first","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Cairo University","place":["Cairo, Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed S.","family":"Ragab","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Port Said University","place":["Port Said, Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelhalem Showkat","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Menia University","place":["Menia, Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud Tarek","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Cairo University","place":["Cairo, Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed E.","family":"Arafat","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Cairo University","place":["Cairo, Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelhafeez Mohamed","family":"Abdelhafeez","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Beni Suef University","place":["Beni Suef, Egypt"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1177\/0009922812458354","article-title":"Hirschsprung disease in the older child: diagnostic strategies","volume":"51","author":"Maerzheuser","year":"2012","journal-title":"Clin Pediatr (Phila)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1089\/lap.2020.0549","article-title":"Long-term results of one-stage laparoscopic-assisted endorectal pull-through for rectosigmoid Hirschsprung\u2019s disease in patients aged above 5 years","volume":"31","author":"Chan","year":"2021","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"B3","first-page":"241","article-title":"Hirschsprung en ni\u00f1os mayores de seis a\u00f1os [Hirschsprung in children over 6 years of age]","volume":"67","author":"Baeza-Herrera","year":"2002","journal-title":"Rev Gastroenterol Mex"},{"key":"B4","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1186\/1756-0500-7-410","article-title":"Hirschsprung's disease in children: a five-year experience at a University teaching hospital in northwestern Tanzania","volume":"7","author":"Mabula","year":"2014","journal-title":"BMC Research Notes"},{"key":"B5","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1089\/lap.2011.0081","article-title":"10 years of experience with laparoscopic-assisted endorectal soave pull-through procedure for Hirschsprung\u2019s disease in China","volume":"22","author":"Tang","year":"2012","journal-title":"J Laparoendosc Adv Surg Tech"},{"key":"B6","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.jpedsurg.2008.10.030","article-title":"Development of a standardized definition for Hirschsprung-associated enterocolitis","volume":"44","author":"Pastor","year":"2009","journal-title":"J Pediatr Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1053\/j.sempedsurg.2012.07.006","article-title":"Hirschsprung-associated enterocolitis: prevention and therapy","volume":"21","author":"Frykman","year":"2012","journal-title":"Semin Pediatr Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"151078","DOI":"10.1016\/j.sempedsurg.2021.151078","article-title":"Outcomes in Hirschsprung disease","volume":"30","author":"Levitt","year":"2021","journal-title":"Semin Pediatr Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1016\/0022-3468(95)90681-9","article-title":"Rectal irrigation and preoperative colonic decompression in Hirschsprung disease","volume":"30","author":"Marty","year":"1995","journal-title":"J Pediatr Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.ijscr.2015.09.005","article-title":"One-stage laparoscopy-assisted endorectal pull-through for late presented Hirschsprung\u2019s disease-case series","volume":"16","author":"Nam","year":"2015","journal-title":"Int J Surg Case Rep"},{"key":"B11","doi-asserted-by":"publisher","first-page":"68","DOI":"10.4103\/0971-9261.33210","article-title":"Hirschsprung disease; 8 years\u2019 experience in a Nigerian teaching hospital","volume":"12","author":"Nasir","year":"2007","journal-title":"J Indian Ass Peditr Surg"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1773691\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:02:46Z","timestamp":1772607766000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1773691\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,4]]},"references-count":11,"alternative-id":["10.3389\/fsurg.2026.1773691"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1773691","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,4]]},"article-number":"1773691"}}