Comparison of two techniques for single-stage treatment of Hirschsprung disease in neonates

Introduction: The aim of this study is to determine the incidence, morbidity and functional outcome of two techniques for Hirschsprung disease (single-stage Duhamel pull-through and tans-anal pull-through) in the neonatal age group. Method: All the neonates with Hirschsprung disease with short aganglionic segment (transition zone at recto-sigmoid junction) admitted during the last 6 years were included. A total of 44 cases were included in the study of which 24 were treated by Duhamel pullthrough (group A) and 20 were treated with trans-anal pull-through (TEPT, group B). The time of operation, acceptance of first oral feed, duration of hospital stay, complications and anal continence were evaluated for both procedures. Result: There was no difference in age and sex and length of the aganglionic segment of bowel. The average operative time was 140-180 min. in group A and 120-170 min. in group B. Per-oral feed was started on the 5-7th day in group A and on the 5-6th day in group B. Hospital stay was longer in group A whereas complications were more common in group B and were found to be statistically significant. Anal continence was almost similar in both groups. Conclusion: Single-stage Duhamel pull-through operation is better than trans-anal pull-through operation in long-term follow-up although duration of hospital stay was shorter in TEPT.