pull-through procedure
A family of surgical operations used to treat Hirschsprung disease, in which the aganglionic bowel segment is resected and normally innervated bowel is anastomosed to the anal canal.
Full Definition
Pull-through procedures are the definitive surgical treatment for Hirschsprung disease, involving resection of the aganglionic distal bowel and anastomosis of ganglionated proximal bowel to the anorectal junction. Major named variants include the Swenson, Duhamel, and Soave procedures, each differing in the level of dissection and residual rectal cuff retained. Pathology specimens from pull-through surgery require careful mapping of the proximal and distal margins for ganglion cell presence. Editors encountering these terms in operative notes or pathology reports should not alter them to generic descriptions such as 'bowel resection', as the specific technique carries clinical significance.
Usage
Usage note: Hyphenate as 'pull-through' when used as a compound modifier or as a noun in surgical contexts. Do not substitute with 'bowel reanastomosis'.
In Context
- "The Soave pull-through procedure was performed at six months of age following confirmed long-segment Hirschsprung disease." — Operative summary
- "Post-pull-through biopsy specimens must include the proximal resection margin to confirm the presence of ganglion cells." — Pathology specimen submission protocol