Abstract

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
postoperative complications.