J Korean Assoc Pediatr Surg.  2007 Jun;13(1):61-65.

One-stage Repair of Neonatal Hirschsprung's Disease

Affiliations
  • 1Division of Pediatric Surgery, Department of Surgery, HanYang University, Seoul, Korea. pmjung@hanyang.ac.kr

Abstract

Conventional treatment of Hirschsprung's disease consists of initial colostomy followed by pull-through operation. But, the treatment of Hirschsprung's disease has been changed along with the development of new surgical technique. Since 1995, endo-GIA has been available at our hospital and one stage Duhamel operation has been performed for neonatal Hirschsprung's disease. Between May 1995 and April 2006, 26 neonates have been treated with one stage pull-through operation by one pediatric surgeon at HanYang University Hospital. The sex ratio was 4.2:1 with male predominance. Clinical findings included abdominal distension (96.2 %), vomiting (50.0 %), delayed passage of meconium (46.2 %), constipation (23.1 %), and enterocolitis (15.4 %). Twenty two cases (84.6 %) were short-segment and 4 cases (15.4 %) were long-segment disease, of which 2 cases were total colon aganglionosis. One of the two patients with total colonic aganglionosis had double transition zones - distal ileum and hepatic flexure of the colon. The average age at operation was 14.56 +/- 8.77 days and the average weight at operation was 3.26+/-0.66 kg. Primary Duhamel operations were performed in 25 patients and Soave-Boley operations was performed in one patient. The endo-GIA 35 (Ethicon, USA) was used from 1995 until 1997, and after that endo-GIA 60 (USSC, USA) was used. The average Duhamel operation time was 88.57 +/- 22.80 minutes. Wound abscess (n = 2) and septum formation (n =1) occurred after Duhamel operation. Bowel function was normalized in 59 % within 3 months and in 95% within 1 year after operation. There was no mortality after one stage pull-through operation in neonate.

Keyword

Hirschsprung's disease; Duhamel operation

MeSH Terms

Abscess
Colon
Colostomy
Constipation
Enterocolitis
Hirschsprung Disease*
Humans
Ileum
Infant, Newborn
Male
Meconium
Mortality
Sex Ratio
Vomiting
Wounds and Injuries
Full Text Links
  • JKAPS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr