Swenson's operation for neonatal Hirschsprung's disease

Abstract

Objective: To describe our experience with Swenson's operation for Hirschsprung's disease done during the neonatal period.

Design: Retrospective study.

Setting: University department of paediatric surgery.

Subjects: 10 Neonates with Hirschsprung's disease.

Interventions: Rectosigmoidectomy and pull through (Swenson's operation), with covering transverse colostomy.

Main outcome measures: Mortality, morbidity, and continence.

Results: The median age at definitive operation was 25 days (range 15-35). There was one late death three weeks after discharge from hospital of respiratory and cardiac failure. Two patients presented with caecal perforation and two with intestinal obstruction; in all four Hirschsprung's disease was diagnosed on frozen section, a transverse colostomy was done, and the Swenson's operation was done electively. The other six were diagnosed by barium enema examination and biopsy, and underwent total bowel irrigation followed by Swenson's operation and transverse colostomy. The colostomies were closed three to four weeks later. There were no postoperative complications. All nine surviving patients were continent (3-4 stools/day), at a mean (SD) follow up of 21 (5) months.

Conclusion: With the current high standards of anaesthesia and neonatal intensive care, and an experienced surgeon, Swenson's operation for neonatal Hirschsprung's disease is safe and the procedure of choice for this condition.