Transanal pullthrough for Hirschsprung disease: matched case-control comparison of Soave and Swenson techniques.
BACKGROUND
Both the Swenson and the Soave procedures have been adapted to a transanal approach. The purpose of this study was to compare outcomes following the transanal Swenson and Soave procedures using a matched case control analysis.


METHODS
A retrospective chart review was performed to identify all transanal Soave and Swenson pullthroughs done at 2 tertiary care children's hospitals between 2000 and 2010. Patients were matched for gestational age, mean weight at time of the operation, level of aganglionosis, and presence of co-morbidities. Student's t-test and chi-squared analysis were performed.


RESULTS
Fifty-four patients (Soave 27, Swenson 27) had adequate data for matching and analysis. Mean follow-up was 4±1.6 years and 3.2 ±2.7 years for the Soave and Swenson groups, respectively. No significant differences in mean operating time (Soave:191±55, Swenson:167±61 min, p=0.6), overall hospital stay (6±4 vs 7.8±5 days, p=0.7), and number with intra-operative complications (3 vs 4, p=1.0), post-operative obstructive symptoms (6 vs 9, p=0.5), enterocolitis episodes (4 vs 4, p=1.0), or fecal incontinence (0 vs 2, p=0.4) were noted.


CONCLUSIONS
After controlling for potential confounders, there were no significant differences in the short and intermediate term outcome between transanal Soave and transanal Swenson pullthrough procedures.
Division of Pediatric Surgery, Children's Hospital of Eastern Ontario, University of Ottawa. Electronic address: anasr@cheo.on.ca.
Ahmed
A
Nasr
Division of Pediatric Surgery, Children's Hospital of Eastern Ontario, University of Ottawa.
Ramanath N
RN
Haricharan
Division of Pediatric Surgery, Children's Hospital of Eastern Ontario, University of Ottawa.
Julie
J
Gamarnik
Division of General and Thoracic Surgery, The Hospital for Sick Children, Department of Surgery, University of Toronto.
Jacob C
JC
Langer
D001003:Anal Canal / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D004760:Enterocolitis / Q000209:etiology; D005242:Fecal Incontinence / Q000209:etiology; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications; D007902:Length of Stay; D016555:Matched-Pair Analysis; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome
Children; Hirschsprung disease; Operative repair; Soave; Swenson; Transanal