PRIMARY MODIFIED DUHAMEL OPERATION FOR HIRSCHSPRUNGS-DISEASE IN INFANTS

A primary Duhamel pull-through procedure without a covering colostomy was performed for Hirschsprung's disease in 22 infants from 1987 to 19 92. The age range at operation was 14 to 90 days (mean 43.7 days). The average weight at surgery was 3.69 kg (2.28-6.20 kg). The most common level of aganglionosis was rectosigmoid (50%). A one-stage Duhamel pr ocedure using a Proximate (Ethicon, Somerville, USA) linear anastomosi ng instrument (PLC50) was performed in all cases. Postoperative morbid ity occurred in 4 patients (18%). There were no associated deaths. Pri mary corrective treatment without an enterostomy and the feasibility o f utilizing a stapling device for the colorectal anastomosis in infant s under 3 months of age using the Duhamel retrorectal, transanal pull- through for Hirschsprung's disease is discussed.