Dr.Getachew, Hanna(Associate Professor of General & Pediatric Surgery)Tesfay, Hadush2022-01-242023-11-052022-01-242023-11-052021-11http://etd.aau.edu.et/handle/123456789/29601Background: HSD is a developmental disorder of the intrinsic nervious system of the distal colon. The management is pull through procedure and majority of patients do well after surgery; but 32% of patients continue to have complaints after surgery & up to 8.6% of patients can require repeat pull through. Objective: To describe indications for reoperation, surgical technique adopted, complications, and outcome of patients who underwent a redo pull-through procedure in Tikur Anbessa hospital, Ethiopia from Methodology: Retrospective descriptive study design was used and the sampling procedure was a multistage sampling. Descriptive statistics (mean, SD, frequency, percentage, graph and table) was generated by using SPSS version 21. Results: In our study a total of 18(4.87% of all PT) patients underwent redo pull through from 2010- 2019. 13 (72.2%) were males & 5 (27.8%) were females with male to female ratio of 2.6:1. Soave pull through was the most frequent type of pull through on first time; done on 16(94.2%) of patients, two being primary TERPT, and Duhamel pull through for one(5.9%) patient. The type of initial PT wasn’t known in one. The indication for redo PT was pathologically confirmed persistent/aquired aganglionosis in 8(50%) patients. 5(27.8%) patients had anastomotic site stricture confirmed with examination under anesthesia. Three of them were done for persistent obstructive features with clinical impression of aganglionosis. Twisted colon & anastomotic failure with colonic retraction accounted for one patient each. Swenson procedure was performed on 15 (83.3%)patients & Soave pull through was done on 3(16.7%) patients as the procedure for the redo PT. Long term outcome of patients after redo pull through was measured using Holschneider’s FII score. Of the patients FII score was obtained (11 of them), 6 patients achieved good continence,3 has fair continence sttus & one patient was incontinent & required bowel management program to stay clean. One patient was less than 4 years old & not toilet trained yet. In 7 patients the Hilschneider FII score couldn’t be obtained. Conclusion : The indication for redo pull through was persistent obstructive features in 77.8% of patients. The causes of persistent obstructive symptoms after an initial pull-through procedure are pull through of aganglionated segment (50%) and anastomotic site stricture (27.8%). 81.8% of those for whom the Holschneider FII score was obtained has fair t good continence.en-USPatients, Reoperation,Surgical techniqueThesis