Management of Hirschsprung's disease: a comparison of Soave's and Duhamel's pull-through methods

Abstract

The aim of this study was to compare the safety and benefits of Soave's and Duhamel's pull-through procedures for the management of Hirschsprung's disease (HD). The patients consisted of 33 boys (85%) and six girls (15%), a ratio of 5.5:1. Their ages ranged from 1 day to 8 years. Rectal biopsy was performed to confirm the diagnosis of HD. Twenty-five patients (64%) underwent Soave's pull-through, and 13 patients (33%) underwent Duhamel's pull-through. Twenty children (80%) out of the 25 undergoing Soave's pull-through recovered uneventfully, compared with 11 out of the 13 (84%) undergoing Duhamel's pull-through. The complications following Soave's procedure included strictures in two patients (8%), enterocolitis in another two (8%), and anastomotic leakage in one (4%). Additional operations were required in two patients (8%). The complications following Duhamel's procedure included stricture in one patient (7.6%) and enterocolitis in another (7.6%). An additional operation was required in one patient (7.6%). The rate of constipation was 16% after the Soave's pull-through compared with 15% after the Duhamel's pull-through. There was no significant difference between the two procedures in postoperative surgical morbidity or in long-term risk of enterocolitis. In the light of present findings, both procedures appear comparable in terms of efficiency and associated complications.