Endorectal pull-through for Hirschsprung's disease: 17-year review of results in Ukraine

Several surgical procedures are available for the treatment of Hirschsprung's disease (HD) the choice often depends on the surgeon's preference. The procedure that is most convenient for the surgeon is not necessarily the optimal one for the patient, however, and complications and mortality need to be considered. We reviewed our series of 275 children operated upon for HD by endorectal pull-through after Soave-Boley dissection of the seromuscular cuff followed by a hand-sutured (HSA) (210) or stapled (SA) (65) primary perineal colorectal anastomosis. Early postoperative complications were documented in 13 children with a HSA and 5 with a SA Follow-up was from 6 months to 15 years for HSA patients with and from 1 month to 3 years after SA. Results were good or satisfactory; there were no unsatisfactory results. On long-term follow-up the complication rate after SA (13.8%) was comparable to that after HSA (20.5%). The overall complication rate on long-term follow-up was 2.91%, which is comparable to results published in the literature. The SA is particularly convenient for surgeon, as it allows a simpler and shorter operation than with the traditional HSA.