Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1985 Sep;202(3):349–355. doi: 10.1097/00000658-198509000-00012

A ten-year experience with ninety-two cases of Hirschsprung's disease. Including sixty-seven consecutive endorectal pull-through procedures.

T Z Polley Jr, A G Coran, J R Wesley
PMCID: PMC1250915  PMID: 4037907

Abstract

From July 1974 through November 1984, 92 patients with Hirschsprung's disease (congenital aganglionosis) have been treated at the University of Michigan-Mott Children's Hospital. This series includes 67 consecutive modified endorectal pull-through (ERPT) procedures in children. Fifty-one of these 67 patients had standard rectosigmoid disease and underwent a successful ERPT with only two major complications. One of these 51 children underwent a successful ERPT but died in the late postoperative period from severe congenital heart disease. Eighteen of the 92 patients suffered from total aganglionosis or long-segment disease. Sixteen of these have undergone an ERPT with no mortality or operative morbidity. The follow-up ranges from 6 months to 10 years. All of the children who have reached 3 years of age are continent. Of the remaining 23 patients, 12 were referred following an unsuccessful pull-through at another hospital. The 12 operations included five Swenson pull-throughs, five Duhamel procedures, one ERPT, and one subtotal colectomy. It was possible to redo or revise the pull-through procedures successfully in all but one patient, who required a permanent colostomy. Finally, 11 children were referred for management of a variety of complications following pull-through procedures performed at other institutions. None of these 11 patients required a reperformance of their pull-through, and all were successfully treated with lesser surgical procedures or with medical management. The excellent functional results and the low morbidity and zero operative mortality are attributed to the technical ease of performing the modified ERPT.

Full text

PDF
349

Images in this article

353FIG. 2.
on p.353

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BOLEY S. J. NEW MODIFICATION OF THE SURGICAL TREATMENT OF HIRSCHSPRUNG'S DISEASE. Surgery. 1964 Nov;56:1015–1017. [PubMed] [Google Scholar]
  2. Coran A. G., Sarahan T. M., Dent T. L., Fiddian-Green R., Wesley J. R., Jordan F. T. The endorectal pull-through for the management of ulcerative colitis in children and adults. Ann Surg. 1983 Jan;197(1):99–105. [PMC free article] [PubMed] [Google Scholar]
  3. Jordan F. T., Coran A. G., Weintraub W. H., Wesley J. R. An evaluation of the modified endorectal procedure for Hirschsprung's disease. J Pediatr Surg. 1979 Dec;14(6):681–685. doi: 10.1016/s0022-3468(79)80244-4. [DOI] [PubMed] [Google Scholar]
  4. Jordan F. T., Coran A. G., Wesley J. R. Modified endorectal procedure for management of long-segment aganglionosis. Ann Surg. 1981 Jul;194(1):70–75. doi: 10.1097/00000658-198107000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Klein M. D., Coran A. G., Wesley J. R., Drongowski R. A. Hirschsprung's disease in the newborn. J Pediatr Surg. 1984 Aug;19(4):370–374. doi: 10.1016/s0022-3468(84)80255-9. [DOI] [PubMed] [Google Scholar]
  6. Kleinhaus S., Boley S. J., Sheran M., Sieber W. K. Hirschsprung's disease -- a survey of the members of the Surgical Section of the American Academy of Pediatrics. J Pediatr Surg. 1979 Oct;14(5):588–597. doi: 10.1016/s0022-3468(79)80145-1. [DOI] [PubMed] [Google Scholar]
  7. SOAVE F. HIRSCHSPRUNG'S DISEASE: A NEW SURGICAL TECHNIQUE. Arch Dis Child. 1964 Apr;39:116–124. doi: 10.1136/adc.39.204.116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Sarahan T., Weintraub W. H., Coran A. G., Wesley J. R. The successful management of chronic constipation in infants and children. J Pediatr Surg. 1982 Apr;17(2):171–174. doi: 10.1016/s0022-3468(82)80204-2. [DOI] [PubMed] [Google Scholar]
  9. Swenson O., Sherman J. O., Fisher J. H., Cohen E. The treatment and postoperative complications of congenital megacolon: A 25 year followup. Ann Surg. 1975 Sep;182(3):266–273. doi: 10.1097/00000658-197509000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Weintraub W. H., Heidelberger K. P., Coran A. G. A simplified approach to diagnostic rectal biopsy in infants and children. Am J Surg. 1977 Aug;134(2):307–310. doi: 10.1016/0002-9610(77)90371-3. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES