Initial experience with Soave's transabdominal pull-through: an observational study.

PURPOSE: The purpose of this study was to evaluate the clinical profile and outcome of patients with Hirschsprung's disease undergoing Soave's transabdominal pull-through.

METHODS

The study is a prospective study in neonates, infants and children presenting to Surgery Department of B. P. Koirala Institute of Health Sciences, Dharan, Nepal with a diagnosis of Hirschsprung's disease who underwent a Soave's transabdominal pull-through from 2006 to 2008.

RESULTS

There were 20 patients, including 10 neonates (50%), 8 infants (40%) and 2 children (10%). There were 18 males and 2 females. Mean age at presentation was 9.2 months (range 7 days-7 years). Mean time of passing stool postoperatively was 49.5h (range 15-72h). Mean time to orally allowing was 97.2h postoperatively (range 36-120h). Mean hospital stay was 14.4 days (range 11-19days). One patient died due to uncontrollable hyperthermia (5% mortality). Other complications noted were 1(5.2%) anastomotic leak, 1(5.2%) cuff abscess and 1(5.8%) anastomotic stricture. Mean stool frequency at 1st month of follow-up was 6.8 per day, which later decreased to 4.5 per day at 3rd month, 3.1 per day at 6th month and 1.7 at 1 year. Two patients (11.7%) have constipation at 1 year follow-up.

CONCLUSION

The rate of complications like mortality, cuff abscess, anastomotic leak and constipation are comparable to other series. The short-term results of Soave's transabdominal pull-through have been satisfactory; however long-term results are still awaited.