Experience with a modification of Duhamel-Grob-Martin operation for the treatment of Hirschsprung's disease.

Forty-two patients have been operated upon with the Duhamel-Grob-Martin operation to which has been added a partial sphincterotomy. Three patients developed anastomotic leaks and one of these died. In follow-up studies from 2 months to 9 years after operation, all patients were relieved of distension and constipation, except two, who were considered to have had an incomplete proximal resection of aganglionic bowel. There were two children with repeated attacks of enterocolitis after operation. Fecal control was good in all and, in spite of the retention of a considerable spur, there have been no problems from this. It is considered that the internal sphincter is involved in the disease and the possibility of persistent obstructive symptoms is reduced by the internal sphincterotomy which has not resulted in incontinence.