Abstract: Aim of the Study: The aim of this study is to compare outcomes for infants with 
Hirschsprung's disease undergoing a TERPT procedure with those undergoing a 
laparoscopically assisted transanal pull-through (LAPT). Methods: Forty patients with 
Hirshsprung Disease were operated between January 2016 and January 2019 was reviewed. 
Twenty patients underwent transanal endorctal pullthrough TERPT while the other 20 
patients underwent laparoscopic assisted pull through LAPT. Age at operation, presenting 
symptoms, operative time complications and degree of continence were evaluated. Bowel 
functions were assessed using the Cleveland Clinic Incontinence Score. Ethical procedures 
including obtaining informed consent were conducted in accordance with the ethical 
standards of the Committee on Human Experimentation of Minia University. Results: The 
mean age of the patients at the time of operation were 18.9 month for the transanal group 
versus 21.3 months for the laparoscopic group. The mean follow-up period was 6 month, 
ranging from 3 to 12 month. The rate of enterocolitis occurred in 15% of cases in transanal 
group versus 30% of cases in the laparoscopic group. Constipation was found in 25% of cases 
of TERPT group versus 10% of cases in the LAPT group. The rates of normal continence 
(score 0:4) was 60% vs 50% for TERPT vs LAPT respectively while the rate of severe 
incontinence (score 15:20) was 20% vs 5% for TERPT vs LAPT respectively. Conclusion:
The functional outcomes after LAPT was satisfactory in term of fecal soiling compared to 
trans anal approach this may be due to less pelvic dissection comared to trans anal pull 
through.