One-stage operation for Hirschsprung's disease: experience with 192 cases.

OBJECTIVE

To report early and late outcomes after a one-stage operation for Hirschsprung's Disease (HD).

METHODS

Between December 2001 and December 2004, 192 patients (165 boys and 27 girls) underwent a one-stage operation for HD. Operative techniques included modified Pfannenstiel incision (48 cases), modified posterior sagittal approach (64 cases), and primary laparoscopic-assisted endorectal colonic pull-through procedure (80 cases). Ages ranged from 15 days to 36 months. The diagnosis was confirmed by operative frozen biopsies.

RESULTS

An aganglionic segment was located in the rectum in 105 patients, in the sigmoid colon in 83 and in the left colon in four. There were no operative deaths. In one patient, a small intestinal perforation occurred 3 days after operation and required ileostomy. Anastomotic leakage occurred in four patients treated by modified posterior sagittal approach. The median hospital stay was 6 days, excluding five patients who required enterostomy. One hundred and forty-five patients were followed-up for 6-40 months after discharge from the hospital. All patients had spontaneous defaecation. The stool frequency ranged from one to four times daily in 113 patients, five to six times in 13, and over six times in four patients. There were seven patients with faecal incontinence and eight with constipation.

CONCLUSION

One-stage operation is a safe procedure for HD.