From
StayCurrentMD
Update Course Rewind 2025: Hirschsprung’s Pull-Through: Why Family Training May Save Lives
hosted by Dr. Jill Knepprath
Chapter 1 of 4 · Fundamentals
Poll results
Introduction and Audience Poll on Pull-Through Timing
Expert statements on this page
No expert statements were drawn from this page.
Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
In the literature, there is not really evidence of good timing to perform a pull-through procedure for Hirschsprung disease.
A 2021 PCPLC retrospective study compared outcomes of neonatal pull-through versus delayed primary pull-through for Hirschsprung disease.
One expert delays pull-through at least 1 month, sometimes 3 months, depending on when the family can return, because they want families to demonstrate they can do irrigations at home.
Family skill in performing irrigations is an important skill for Hirschsprung patients.
Families who are really good at irrigations will save a baby's life in Hirschsprung disease.
Children whose families cannot perform adequate washouts may not be able to go home and remain inadequately decompressed, leading to hospitalization with colitis or perforation.
The median age of the neonatal pull-through group was 11 days at time of surgery.
The median age of the delayed pull-through group was 98 days at time of surgery.
The PCPLC study found no difference in preoperative enterocolitis between neonatal and delayed pull-through groups.
The PCPLC study found no difference in postoperative enterocolitis between neonatal and delayed pull-through groups.
The PCPLC study found no difference in fecal incontinence at follow-up between neonatal and delayed pull-through groups.