title: Laparotomic versus laparoscopic Duhamel pull-through for Hirschsprung disease in infants and children.
abstract: OBJECTIVE
  The aim of this study was to analyze the results from laparotomic and laparoscopic Duhamel pull-through in the treatment of Hirschsprung disease.
  
  
  METHODS
  In our department, the Duhamel pull-through technique was adopted in most patients and the laparoscopic technique used since 1999 follows the original Duhamel procedure. Patients were identified retrospectively and followed up in our outpatient clinic. Preoperative, operative, and postoperative data were collected and analyzed.
  
  
  RESULTS
  Between January 1992 and March 1999, 21 children with Hirschsprung disease underwent primary surgical correction using the classic open Duhamel pull-through. The mean age at operation was 14 months, the median operating time was 297 minutes, and the average postoperative stay was 10 days. From April 1999 to December 2003, 22 children underwent laparoscopic Duhamel pull-through. The mean age at operation was 14.6 months, the mean operative time was 253 minutes, and the mean postoperative stay was 6.8 days. The rates of early (4.7% vs. 4.7%) and late (19% vs. 23.8%) complications were similar in the two groups, but in the laparoscopic group the mean operative time and postoperative hospital stay were lower.
  
  
  CONCLUSIONS
  With these encouraging results, laparoscopic Duhamel pull-through has become our procedure of choice in the surgical management of Hirschsprung's disease.
authors.affiliation: Clinic of Pediatric Surgery, University of Padova, Padova, Italy.
authors.forename: Vittorina
authors.initials: V
authors.lastname: Ghirardo
authors.forename: Pietro
authors.initials: P
authors.lastname: Betalli
authors.forename: Guendalina
authors.initials: G
authors.lastname: Mognato
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Gamba
mesh_terms: D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors