A 40-year multinational retrospective study of 880 Swenson procedures

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Colorectal Surgery

Background:

• The Swenson procedure is a surgical treatment for Hirschsprung's disease.
• Long-term outcomes and complications require comprehensive review.

Purpose of the Study:

• To review the long-term outcomes and complications of the Swenson procedure.
• To identify factors influencing postoperative mortality and morbidity.

Main Methods:

• Retrospective review of 880 patients undergoing the Swenson procedure across seven cities.
• Data collection via hospital records, physician records, and patient interviews (in-person/telephone).
• Follow-up evaluation obtained for 814 patients, averaging 10.3 years.

Main Results:

• Overall postoperative mortality was 2.4%, decreasing to 1.25% in the last 20 years.
• Factors influencing mortality included Down's syndrome, patient age, and distal colonic anastomosis leak.
• Most patients with >5 years follow-up reported normal bowel habits, daily bowel movements, and no soiling; no urinary incontinence or impotence reported.

Conclusions:

• The Swenson procedure demonstrates acceptable long-term outcomes for Hirschsprung's disease.
• Early identification and management of risk factors can improve surgical outcomes.
• The procedure is associated with low rates of long-term functional deficits.