SWENSON OPERATION FOR NEONATAL HIRSCHSPRUNGS-DISEASE

Objective: To describe our experience with Swenson's operation for Hir schsprung's disease done during the neonatal period. Design: Retrospec tive study. Setting: University department of paediatric surgery. Subj ects: 10 Neonates with Hirschsprung's disease. Interventions: Rectosig moidectomy and pull through (Swenson's operation), with covering trans verse colostomy. Main outcome measures: Mortality, morbidity, and cont inence. Results: The median age at definitive operation was 25 days (r ange 15-35). There was one late death three weeks after discharge from hospital of respiratory and cardiac failure. Two patients presented w ith caecal perforation and two with intestinal obstruction; in all fou r Hirschsprung's disease was diagnosed on frozen section, a transverse colostomy was done, and the Swenson's operation was done electively. The other six were diagnosed by barium enema examination and biopsy, a nd underwent total bowel irrigation followed by Swenson's operation an d transverse colostomy. The colostomies were closed three to four week s later. There were no postoperative complications. All nine surviving patients were continent (3-4 stools/day), at a mean (SD) follow up of 21 (5) months. Conclusion: With the current high standards of anaesth esia and neonatal intensive care, and an experienced surgeon, Swenson' s operation for neonatal Hirschsprung's disease is safe and the proced ure of choice for this condition.