{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:57:06Z","timestamp":1790575026534,"version":"4.1.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"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":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The study aimed to evaluate different surgical techniques in total colonic aganglionosis cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Twenty patients were included in this study. A total colectomy, except for the lower rectum in cases of Duhamel's. The average age for an ileal pull-through in ileostomized cases was 1 year; ileostomy closure was performed after 3 years. In eight non-ileostomized cases, surgery was performed at 2\u20133 years of age. Group A comprised 10 cases that underwent direct ileoanal pull-through (seven open and three laparoscopic), while Group B comprised 10 cases that underwent Duhamel's procedure (six laparoscopic and four open). Operative details and postoperative outcomes were recorded for the entire cohort. Comparative statistical analysis was performed on patients with complete follow-up data (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All patients were followed up for 5 years after surgery. Postoperative complications included fecal incontinence, perianal dermatitis, electrolyte disturbances, enterocolitis, and constipation. Fecal incontinence and electrolyte disturbances were more frequently observed after straight ileoanal pull-through, whereas enterocolitis and constipation were more common after Duhamel's procedure. No anastomotic leakage was reported. Comparative analysis showed no statistically significant differences between the two techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No clear superiority was demonstrated between straight ileoanal pull-through and Duhamel's procedure in patients with total colonic aganglionosis. Each technique was associated with a distinct pattern of complications, and larger studies are needed to better define optimal surgical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1846434","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:44:00Z","timestamp":1790574240000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical strategies for total colonic aganglionosis: a retrospective comparative study"],"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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelhalem Showkat","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Faculty of Medicine, Minia University","place":["Minia, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"E. Arafat","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Cairo University","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belal","family":"Elezaby","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Cairo University","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud Marei","family":"Marei","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Cairo University","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seham","family":"Anwar","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Beni Suef University","place":["Beni Suef, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Azzam","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Cairo University","place":["Cairo, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed S.","family":"Ragab","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Department, Faculty of Medicine, Port Said University","place":["Port Said, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1016\/S0022-3468(98)90515-2","article-title":"Long-term morbidity in total colonic aganglionosis","volume":"33","author":"Hoehner","year":"1998","journal-title":"J Pediatr Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2226","DOI":"10.1016\/j.jpedsurg.2008.08.049","article-title":"Total colonic aganglionosis with or without small bowel involvement: a 30-year retrospective nationwide survey in Japan","volume":"43","author":"Ieiri","year":"2008","journal-title":"J PediatrSurg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1016\/j.jpedsurg.2005.03.043","article-title":"Long-term outcomes in total colonic aganglionosis: a 32-year experience","volume":"40","author":"Escobar","year":"2005","journal-title":"J Pediatr Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1007\/s00383-011-2960-y","article-title":"Total colonic aganglionosis: a surgical challenge. 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Pediatr Surg."},{"key":"B17","doi-asserted-by":"publisher","first-page":"31","DOI":"10.3969\/j.issn.1671-6353.2020.01.006","article-title":"Single-site laparoscopic-assisted Martin-Duhamel procedure in the treatment of total colonic aganglionosis with stage \u2160 stoma and evaluation of postoperative defecation function J","volume":"19","author":"Xu","year":"2020","journal-title":"Clin Ped Sur."},{"key":"B18","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1016\/j.jpedsurg.2023.10.017","article-title":"Duhamel versus Swenson pull-through for total colonic aganglionosis: a multi-institutional study","volume":"59","author":"Halaweish","year":"2024","journal-title":"J Pediatr Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1002\/bjs5.50317","article-title":"Totalcolonic aganglionosis: multicentre study of surgical treatment and patient-reported outcomes up to adulthood","volume":"4","author":"Stenstr\u00f6m","year":"2020","journal-title":"BJS Open"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1846434\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:44:01Z","timestamp":1790574241000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1846434\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":19,"alternative-id":["10.3389\/fsurg.2026.1846434"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1846434","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"article-number":"1846434"}}