[A modified surgical tehnique in Hirschprung's disease].

The purpose of the study was to evaluate the operative results in patients with Hirschprung's disease, in whom a modified technique was carried out. During a 25-year period, 209 children with Hirschprung's disease were operated on using a modified technique, introduced by Besewits. The patients (177 males and 32 females) were from 4.5 months to 13 years of age, mean 32 months. The essential features of the technique are extra-abdominal anastomosis and external transmucosal resection of aganglionic rectum. Anterior portion of the rectum is preserved, being important for good functional results. The surgery is performed in two stages. In the first stage, normally innervated colon is pulled trough a mucous cylinder of everted rectum. Two weeks later, exteriorized redundant segment of colon is resected at about 0.5 cm from anocutaneus junction. Within the range of numerous contemporary approaches to surgical treatment of Hirschprung's disease, we feel this technique, proved on 209 patients with low mortality, rare complication, and good functional results, is the method of choice for the majority of patients.