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Primary Swenson Pull-Through Compared With Multiple-Stage Pull-Through in the Neonate

Background: In Hirschsprung's disease, the trend has been for earlier performance of definitive surgery. In our institution, primary Swenson pull- through has become the preferred procedure. Methods: Retrospective review of the patients treated for Hirschsprung's disease from January 1988 through March 1998 was performed. Sixty-five patients were identified. Median values, analysis of variance and χ2 were used for comparisons. Results: The multiple-stage group (M, n = 47) was similar to the primary group (P, n = 18) for gestational age (40 v 39 weeks), time to meconium passage (37.9 v 35.5 hours), and age at diagnosis (median, M 27 v P 3.5 days). Age (median, M 268 v P 5 days) and weight (mean, M 9.4 v P 3.7 kg; P < .001) at pull-through were lower in the primary group. Length of stay (LOS) was lower in the primary group (mean, M 40,8 v P 20.3 days; P < .05). Operating time for pull- through was decreased in P (mean, M 305.2 v P 272.2 minutes; P = .02). Total complications were lower in the primary group (P = .03), with no differences in mortality or enterocolitis rates. Conclusions: At our institution there were no increases in total complications or enterocolitis in the group undergoing primary Swenson. Primary pull-through is a viable option for the treatment of Hirschsprung's disease.

Identiferoai:union.ndltd.org:ETSU/oai:dc.etsu.edu:etsu-works-13305
Date01 January 1999
CreatorsSantos, M. C., Giacomantonio, J. M., Lau, H. Y.C.
PublisherDigital Commons @ East Tennessee State University
Source SetsEast Tennessee State University
Detected LanguageEnglish
Typetext
SourceETSU Faculty Works

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