Comparative study between two-stage trans-abdominal Duhamel procedure and two-stage Soave pull-through in treatment of Hirschsprung’s disease: Clinical evaluation

Document Type : Original research articles

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Department of Pediatric Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt

Abstract

Background: Hirschsprung’s disease (HD) is a congenital anomaly affecting the bowel of neonates, due to a defect in the ganglion cells presence in the colon in a caudo-cranial fashion, various surgical techniques used to correct the aganglionic segment, Duhamel procedure, Soave pull-through were used to correct the defect.
Objectives: This study was conducted to compare the clinical outcome of two-stage Duhamel procedure and two-stage Soave pull-through in HD management.
Patients and method: 40 patients diagnosed with Hirschsprung’s disease in the pediatric age group were enrolled in this study, 20 patients operated by Duhamel procedure, and 20 patients operated by Soave pull-through.
Results: Enterocolitis was detected in 40% of patients after Soave pull-through while it was 5% in patients subjected to Duhamel procedure (p=0.020). Stricture was detected in 15% of cases subjected to Soave pull-through, Patients subjected to Duhamel procedure didn’t show stricture without significant difference. Regarding faecal continence, patients operated on by Duhamel procedure had better results compared to two-stage Soave pull-through (p<0.001). Regarding constipation, the differences were not significant between both groups.
Conclusion: Two-stage trans-abdominal Duhamel procedure has significantly better results as regards post-operative continence, constipation, and enterocolitis than Soave endorectal pull-through in the management of HD.

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