الفهرس 
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Abstract
Hirschsprung’s disease (HD) is a congenital aganglionosis of the submucosal and myenteric neural plexuses principally affecting the rectosigmoid or rectal segments of varying lengths. Single-stage pull-through surgery is the standard treatment, and laparoscopy is now commonly used to guide this procedure, however, complete transanal approach without laparotomy or laparoscopy is growing in popularity.
This prospective randomized controlled study was carried out on patients with Hirschsprung’s disease, who admitted to Pediatric surgery department, Ain Shams University hospitals. Informed consent was obtained from all guardians before starting the research. The study design was approved by the Ain Shams Faculty of Medicine’s Ethics Committee.
In this study, patients were randomized into two groups:
group A: (n= 10) patients subjected to pure transanal soave technique.
group B: (n= 10) patients subjected to laparoscopic assisted trananal Soave technique.
This study aims was to compare between pure transanal and laparoscopic assisted soave as regarding intra-operative time (e.g: duration of anal stretch), postoperative hospital stay and complications as (, anastomotic stricture, enterocolitis and diarrhea) in treatment of children with Hirschsprung.
The following was carried out for each subject:
Demographic data and clinical history: Passage of meconium, Age at presentation in months. History of obstructed or Hirschsprung entero-colitis.
General examination: Examining the general condition of the patient regarding the vital data, inspecting for any neurological abnormalities or associated syndromes.
Abdominal examination: inspecting and palpating the abdomen and the colon
Per rectal examination should be done expecting gush of air, stools.
Abdominal X-rays: Showing cut-off level proximal to the affected segment.
Operative data: operative duration, intraoperative complications
Postoperative follow up: total hospital stay, start of oral feeding., anastomotic leakage and continence and stooling scores
Regarding basic clinical characteristics of the studied groups, the current study showed that there was a statistically significant difference between the two groups regarding median age with p value (0.008). While there was no statistically significant difference between the two groups regarding weight at birth with p value (0.909).
Concerning diseases presentation in the studied groups, the present study found that there was no statistically significant difference between the two groups regarding evacuation by suppository, usage of rectal enemas, previous HAEC preoperativee nor the median number of attacks with p value (>0.05).
As regard surgical characteristics of the studied groups, it was detected that there was shows no statistically significant difference between the two groups regarding weight and age at operation, duration of anal stretching, postoperative start of intestinal function, nor total hospital stay with p value (>0.05). However, there was a statistically significant difference regarding duration of the whole operation being longer in the lap group,with no significant difference between the total time of anal stretching
With reference to postoperative complications, the current study reported that there was no statistically significant difference between the two groups regarding anastomotic leakage, remnant rolled cuff, anastomotic stricture, anal achalsia, anal fissure nor post operative enterocolitis with p value (>0.05).