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  • Title: Swenson revisited: a one-stage, transanal pull-through procedure for Hirschsprung's disease.
    Author: Weidner BC, Waldhausen JH.
    Journal: J Pediatr Surg; 2003 Aug; 38(8):1208-11. PubMed ID: 12891494.
    Abstract:
    BACKGROUND: Hirschsprung's disease is a common cause of neonatal intestinal obstruction. A variety of operations have been used to treat this neurogenic form of bowel obstruction. This report describes an experience with a 1-stage abdominal and transanal pull-through operation in 15 patients with rectosigmoid disease. METHODS: Fifteen infants with Hirschsprung's disease included 11 boys and 4 girls. Median age at diagnosis was 3 days, and median age of operation was 30 days. Diagnosis was confirmed by rectal biopsy. Biopsies to confirm the transition zone were performed intraabdominally through a left lower quadrant incision. A Swenson pull-through was performed via transanal dissection. RESULTS: There were no instances of anastomotic leaks, wound infections or postoperative bowel obstructions. All patients survived. Two had postoperative enterocolitis. Twelve of 15 patients did well and had 2-3 bowel motions per day. One with Down's syndrome had enterocolitis and required a colostomy. Two were lost to follow up. CONCLUSIONS: A one-stage transanal pull-through procedure in infancy is a safe alternative to staged procedures for Hirschsprung's disease.
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