Abstract

Objective: Aim of this study was to analyze the results of classic Swenson abdomino-perineal pull through technique in the treatment of Hirschsprung’s disease carried out at our hospital during four years.

Study Design: Prospective observational study

Settings: Pediatric surgery department, KMC Civil hospital Khairpur and GMMMC Civil Hospital Sukkur

Duration of Study: Four years from 1stJuly 2016 to 30thJune 2020

Materials and methods: Total of 40 patients were selected and recruited for the study. Data of pre-operative symptoms and post-operative complications was collected. Gut was prepared for 2 days pre-operatively. All surgeries were performed under general anesthesia in supine position. Selected patients were operated following Classic Swenson abdomino-perineal pull through technique.

Results: 40 patients were selected for the study. Pre-operative clinical feature of the disease included delayed passage of meconium {n=33(82.5%)},constipation {n=24(60%)}, failure to thrive {n=13 (32.5%)}, vomiting {n=9 (22.5%)} and abdominal distension {n=6 (15%)}. No post-operative complications were seen in 32 (80%) patients. Recurrence of constipation was seen in 3 (7.5%) patients. Fecal incontinence was seen in 2 (5%) patients. Urinary incontinence and anastomosis leakage was seen in 1 (2.5%) patient. Enterocolitis was seen in 1 patient {n=1 (2.5%)}. There was no death reported post-operatively. Three (7.5%) patients required a redo surgery due to various complications.

Conclusion: It is concluded in our study that classic Swenson abdomino-perineal pull through procedure in the treatment of hirschsprung’s disease is very efficient technique with very few short term complications.

Keywords: Hirschsprung’s disease, classic Swenson abdomino-perineal, pull through technique.