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.