Laparoscopic Swenson's Pull-Through for Hirschsprung's Disease

摘要

The purpose of this study was to analyze the initial results of laparoscopic Swenson's pull-through in the treatment of Hirschsprung's disease. A three-trocar technique following the principles of the original Swenson's procedure was used for the laparoscopic pull-through. Patients were identified retrospectively and followed up prospectively in the outpatient clinic. Demographic, preoperative, operative, and postoperative data were collected and analyzed. Eleven children underwent a one-stage pull-through with preoperative irrigations. Three children underwent a two-stage procedure with an initial defunctioning colostomy. The average age at surgery was 9.4 months (range 3.2-45.7 months) with a mean operative weight of 8.8 kg (range 5.8-18.4 kg). The mean operative time was 237 min (range 180-305 min). The first oral intake occurred at a mean of 1.5 days (range 0-4 days), and the first bowel movement occurred at 1.6 days (range 1-5 days). The average postoperative stay was 4.4 days (range 3-6 days). In the outpatient follow-up, all patients were gaining weight and stool-ing regularly. There have been no major complications in up to 27 months of follow-up. With these encouraging early results, laparoscopic Swenson's pull-through has become the authors' procedure of choice in the surgical management of Hirschprung's disease.