Abstract
Objective: The purpose of study was to compare Swenson & Soave-Boley procedure in the staged operative treatment of Hirschsprung's Disease (HD). Methods : During 16 months of study period, 25 patients of histopathologically confirmed HD were selected for staged operative treatment, following certain inclusion & exclusion criteria & were admitted & operated at DSH; after completion of all stages operation they were followed up & studied under two groups : staged Swenson procedure (Group-A; na=13) & staged Soave-Boley procedure (Group-B, nb=12). They were similar for age, sex, body weight, reselected length of aganglionic segment & postoperative follow up. The level of ganglionosis was assessed from marking biopsy. Preoperative & postoperative observations of Swenson procedure were analyzed & compared with those of Soave-Boley procedure in the staged operative treatment of HD statistically (unpaired ât' test & Ï2 test) Results : For group A (Swenson procedure) the operative time was significantly lesser (unpaired ât' test : P < 0.01) than for the group B (Soave-Boley procedure). First bowel movement after colostomy closure was also significantly lesser in duration in Swenson procedure (Ï2 Â test :P < 0.05). DOI = 10.3329/jom.v9i1.1420 J MEDICINE 2008; 9 : 16-19 Â
Highlights
Hirschsprung’s Disease (HD) is a development disorder of the enteric nervous system (ENS) characterized by absence of ganglion cells in the myenteric & submucosal plexuses along a variable portion of the distal intestine.[1]
Materials & Methods: This is a prospective study conducted on the children admitted & subsequently operated for Hirschsprung’s disease in the department of Surgery of Dhaka Shishu (Children) Hospital (DSH)
Out of 25 patients of our series 3(12%) patients came from a contagious parents
Summary
Hirschsprung’s Disease (HD) is a development disorder of the enteric nervous system (ENS) characterized by absence of ganglion cells in the myenteric & submucosal plexuses along a variable portion of the distal intestine.[1]. The most widely accepted etiopathogenic hypothesis is based on a defect of craniocaudal migratiion of Neuroblasts originating from the neural crest.[1]. Three most common operations for the definitive treatment of HD are the Swenson, Duhamel & the Soave procedure.[3] each has been modified following its original description, three procedure continue to be used as the standard operations for the definitive treatment of this disease.[4]. Swenson first introduced the abdomino-perineal resection with pull through for HD in 1948. The risk of damage to the sacral nerves responsible for fecal & urinary continence as well as sexual function with the Swenson operation stimulated the development of the other pull through procedure.[4]
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