Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1975 Sep;182(3):266–273. doi: 10.1097/00000658-197509000-00008

The treatment and postoperative complications of congenital megacolon: A 25 year followup.

O Swenson, J O Sherman, J H Fisher, E Cohen
PMCID: PMC1343934  PMID: 1164055

Abstract

In 1948 one of us (O.S.) proposed a new method of treatment, abdominoperineal resection, for patients with congential megacolon. Since then, 483 patients have been treated by 13 pediatric surgeons in Chicago and Boston using this technique. Two hundred and eight-two of the patients were last interviewed and examined more than 5 years after the resection. There were 16 postoperative deaths (3.3%) and 6 late deaths (1.2%) from enterocolitis. Both early and late complications were infrequent and are discussed in detail. Almost 90% of the patients reported that they now have normal bowel habits. None of the patients developed urinary incontinence or impotence, although ten patients (2.1%) reported permanent fecal soiling. This is the first large group of patients treated for congenital megacolon who have been followed to adulthood. The low incidence of postoperative complications and minimal frequency of long-term complications indicate that the abdominoperineal resection is a safe, effective method of treatment for congenital megacolon.

Full text

PDF
266

Selected References

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

  1. Aylett S. O. Three hundred cases of diffuse ulcerative colitis treated by total colectomy and ileo-rectal anastomosis. Br Med J. 1966 Apr 23;1(5494):1001–1005. doi: 10.1136/bmj.1.5494.1001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Burman J. H., Williams J. A., Cooke S. T. The fate of ileorectal anastomosis in Crohn's disease of the large bowel. Gut. 1970 Dec;11(12):1066–1066. [PubMed] [Google Scholar]
  3. DUHAMEL B. A new operation for the treatment of Hirschsprung's disease. Arch Dis Child. 1960 Feb;35:38–39. doi: 10.1136/adc.35.179.38. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Deodhar M., Sieber W. K., Kiesewetter W. B. A critical look at the Soave procedure for Hirschsprung's disease. J Pediatr Surg. 1973 Apr;8(2):249–254. doi: 10.1016/s0022-3468(73)80092-2. [DOI] [PubMed] [Google Scholar]
  5. Fazio V., Turnbull R. B., Jr, Goldsmith M. G. Ileorectal anastomosis: a safe surgical technique. Dis Colon Rectum. 1975 Mar;18(2):107–114. doi: 10.1007/BF02587154. [DOI] [PubMed] [Google Scholar]
  6. Klotz D. H., Jr, Velcek F. T., Kottmeier P. H. Reappraisal of the endorectal pull-through operation for Hirschsprung's disease. J Pediatr Surg. 1973 Oct;8(5):595–600. doi: 10.1016/0022-3468(73)90396-5. [DOI] [PubMed] [Google Scholar]
  7. Marks R. M. Endorectal split sleeve pull-through procedure for Hirschsprung's disease. Surg Gynecol Obstet. 1973 Apr;136(4):627–628. [PubMed] [Google Scholar]
  8. Martin L. W., Altemeier W. A. Clinical Experience with a New Operation (Modified Duhamel Procedure) for Hirschsprung's Disease. Ann Surg. 1962 Oct;156(4):678–681. doi: 10.1097/00000658-196210000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Martin L. W., Caudill D. R. A method for elimination of the blind rectal pouch in the Duhamel operation for Hirschsprung's disease. Surgery. 1967 Nov;62(5):951–953. [PubMed] [Google Scholar]
  10. Polacek M. A., Sanfelippo P. Oral antibiotic bowel preparation and complications in colon surgery. Arch Surg. 1968 Sep;97(3):412–417. doi: 10.1001/archsurg.1968.01340030072005. [DOI] [PubMed] [Google Scholar]
  11. Soave F. Hirschsprung's disease. Technique and results of Soave's operation. Br J Surg. 1966 Dec;53(12):1023–1027. doi: 10.1002/bjs.1800531204. [DOI] [PubMed] [Google Scholar]
  12. Swenson O., Sherman J. O., Fisher J. H. Diagnosis of congenital megacolon: an analysis of 501 patients. J Pediatr Surg. 1973 Oct;8(5):587–594. doi: 10.1016/0022-3468(73)90395-3. [DOI] [PubMed] [Google Scholar]
  13. Weitzman J. J., Hanson B. A., Brennan L. P. Management of Hirschsprung's disease with the Swenson procedure. J Pediatr Surg. 1972 Apr;7(2):157–162. doi: 10.1016/0022-3468(72)90490-3. [DOI] [PubMed] [Google Scholar]

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

RESOURCES