[Results of surgery in children with congenital megacolon]

In 1974 to 1999 at the Department of Paediatric Surgery in Bratislava 142 patients aged 3 days to 14 years were treated on account of Hirschsprung's disease. Seventy-four patients suffered from the classical type of Hirschsprung's disease affecting the recto-sigmoid segment of the large bowel, in 43 the long segment of the large bowel was affected. In nineteen patients an ultrashort segment was afflicted and six patients suffered from total aganglionosis of the large bowel. In 131 patients the diagnosis was established by irrigographic examination and during operation it was confirmed by histological examination of the whole month of the large intestine. In 11 patients the diagnosis was established by peroperative collection of the whole month of the large bowel. In 43 patients the diagnosis was made during the neonatal period. All 142 patients were operated. Nineteen patients with an ultrashort segment were subjected to dorsal myectomy according to Lynn and in 121 patients a retrorectal pull-through according to Duhamel in Ikeda-Soper's modification was performed. In 99 patients before the final operation a colostomy was made, orally from an aganglionic portion of the large bowel. Twenty-two patients were treated in one session by means of a direct stapler without protective colostomy. Two patients died several days after establishment of the colostomy from anaerobic septic complications. After the final operation no death was recorded. Duhamel's operation in Ikeda-Sopor's modification is in the authors' opinion very effective in treatment of congenital megacolon, being associated with a minimum of complications and is the prerequisite for achieving excellent functional results.