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Published on: April 26, 2019
Management of Hirschsprung's disease: a comparison of Soave's and Duhamel's pull-through methods
Waleed Saleh1, Khalid Rasheed, Mohammed Al Mohaidly
1Department of Surgery, Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia.
Insights
This study compared Soave
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Hirschsprung's disease (HD) is a congenital condition affecting the large intestine.
- Surgical management of HD typically involves pull-through procedures.
Purpose of the Study:
- To compare the safety and benefits of Soave's and Duhamel's pull-through procedures for Hirschsprung's disease.
- Evaluate postoperative surgical morbidity and long-term risks.
Main Methods:
- Retrospective analysis of 38 patients with Hirschsprung's disease.
- Comparison of outcomes between Soave's (n=25) and Duhamel's (n=13) pull-through procedures.
- Data collection on complications, recovery, and long-term risks.
Main Results:
- Both Soave's and Duhamel's procedures demonstrated comparable uneventful recovery rates (80% and 84%, respectively).
- Complication rates, including strictures and enterocolitis, were similar between the two groups.
- Long-term constipation rates were also comparable (16% for Soave's vs. 15% for Duhamel's).
Conclusions:
- Soave's and Duhamel's pull-through procedures are comparable in managing Hirschsprung's disease.
- No significant difference in postoperative surgical morbidity or long-term enterocolitis risk was observed.
Abstract:
The aim of this study was to compare the safety and benefits of Soave's and Duhamel's pull-through procedures for the management of Hirschsprung's disease (HD). The patients consisted of 33 boys (85%) and six girls (15%), a ratio of 5.5:1. Their ages ranged from 1 day to 8 years. Rectal biopsy was performed to confirm the diagnosis of HD. Twenty-five patients (64%) underwent Soave's pull-through, and 13 patients (33%) underwent Duhamel's pull-through. Twenty children (80%) out of the 25 undergoing Soave's pull-through recovered uneventfully, compared with 11 out of the 13 (84%) undergoing Duhamel's pull-through. The complications following Soave's procedure included strictures in two patients (8%), enterocolitis in another two (8%), and anastomotic leakage in one (4%). Additional operations were required in two patients (8%). The complications following Duhamel's procedure included stricture in one patient (7.6%) and enterocolitis in another (7.6%). An additional operation was required in one patient (7.6%). The rate of constipation was 16% after the Soave's pull-through compared with 15% after the Duhamel's pull-through. There was no significant difference between the two procedures in postoperative surgical morbidity or in long-term risk of enterocolitis. In the light of present findings, both procedures appear comparable in terms of efficiency and associated complications.
