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The Duhamel/Martin operation in the treatment of Hirschsprung's disease
Abstract:
Thirty-four patients with Hirschsprung's disease, 17 of whom were operated on by the original Duhamel procedure and 17 by the Martin modification are reported on. Thirty-two have had a satisfactory result. Fourteen patients developed early complications. One patient died. Twenty-two have been followed for more than five years. The Martin modification obviates the main disadvantage of the Duhamel operation. A proximal temporary diversionary colostomy or ileostomy greatly reduces the incidence of complications following the pull-through procedures.
Insights
The Martin modification for Hirschsprung's disease surgery offers improved outcomes compared to the original Duhamel procedure. Temporary diversionary colostomy significantly reduces complications in pull-through surgeries.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Hirschsprung's disease is a congenital condition affecting the large intestine.
- Surgical correction is necessary, with Duhamel and Martin procedures being common pull-through techniques.
Purpose of the Study:
- To compare the outcomes of the original Duhamel procedure versus the Martin modification for Hirschsprung's disease.
- To evaluate the impact of temporary diversionary colostomy on surgical complications.
Main Methods:
- Retrospective analysis of 34 patients with Hirschsprung's disease.
- 17 patients underwent the original Duhamel procedure, and 17 underwent the Martin modification.
- Follow-up data, including complications and long-term results, were analyzed.
Main Results:
- Overall, 32 out of 34 patients achieved satisfactory results.
- Fourteen patients experienced early complications.
- The Martin modification demonstrated an advantage over the original Duhamel procedure.
- Temporary diversionary colostomy was associated with a reduced incidence of complications.
Conclusions:
- The Martin modification is a favorable surgical approach for Hirschsprung's disease.
- Incorporating a temporary diversionary colostomy or ileostomy is crucial for minimizing complications.
- Long-term follow-up indicates good outcomes for most patients treated with these pull-through procedures.