Background / Aim : Many definitive
operations exist for Hirshsprung's
disease, each of these operations
is highly effective in the
relief
of functional obstruction, on the
other
hand each operation has
some
complications.The aim of this
study
is to evaluate Swenson's operation
as a method for treatment of
Hirschsprung's
disease and assessment
of short and long term outcome.
Methodology :
Forty patients under went Swen-
son's operation over 4 years, they
were 25 males and 15 females with
mean age 6.64 years (range
6months- 12 years). Preoperative
history and clinical assessment, laboratory,
radiologically and manome- try were done in all cases. Postoperative
evaluation of outcome was
studied.
Results :
No mortality in our cases .Soiling
occured in 2 cases, minor incontinence
in 7 cases (17.5 %) and major
incontinence in 5 cases (12.5 %), enterocolitis
in 5 cases (12.5 %)
.constipation
in 4 cases (10%).
Leakage associated with wound
and pelvic collection in 2 cases (5 %)
and was treated with antibiotics and
leaving the drains for 6 to 8 days.
One case developed rectovaginal fistula,
one case of anal stricture, one
case
of recurrent Hirschsprung s'
disease.
On follow up these symptoms
improved through along the
first
and second year post- operatively. Conclusion:
Swenson's operation is the origi-
nal curative pull- through procedure
especially if precisely performed.
However, it has some complications.
Anal stricture may complicate ischaemia
of the pulled through segment.
Enterocolitis remains a serious
complication.
Incontinence has a relatively
high incidence but with significant
improvement with time.