Management of Hirschsprung's disease: a comparison of Soave's and Duhamel's pull-through methods.
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.
Department of Surgery, Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia.
Waleed
W
Saleh
Khalid
K
Rasheed
Mohammed Al
MA
Mohaidly
Hala
H
Kfoury
Mohammad
M
Tariq
Assia Al
AA
Rawaf
D002648:Child; D002675:Child, Preschool; D039021:Colonic Pouches; D005260:Female; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome