Document Type : Research Article
Purpose: The aim of this study was to compare the clinical outcomes of four surgical procedures to treat
Hirschsprung’s disease (HD) in children.
Materials and methods: One hundred thirty-eight children with HD were included in this retrospective study. The
children underwent four types of pull-through procedures between 2015 and 2020. Sixty-one (44%) children were
older than 3 years of age at the time of surgery. In this study, we evaluated the functional outcome by measuring the
incidence of postoperative complications.
Results: The surgical procedure consisted of 90 transabdominal (modified Soave – n=72; Swenson procedure – n=8;
Swenson-like – n=10) and 48 transanal endorectal pull-through (TEPT) procedures. Early postoperative
complications were seen in 13 children and consisted of faecal incontinence (5; 3.6%), anastomotic stricture (4;
2.8%), and cuff abscess (2; 1.4%); one child had dysuria and anastomotic dehiscence (0.7%). Nine of these early
postoperative complications were after modified Soave pull-through. Episodes of Hirschsprung-associated
enterocolitis occurred more often after transabdominal pull-through procedures (14.4% vs 8.3%; p=.04).
Conclusion: Children who underwent TEPT had a lower rate of postoperative complications, especially episodes of
postoperative Hirschsprung-associated enterocolitis. Therefore, in the treatment of HD in children, preference
should be given to TEPT, which is less traumatic, has better cosmetic outcomes and has low incidences of