Hirschsprung's disease: present UK practice

A postal survey was performed to assess the management by consultant members of the British Association of Paediatric Surgeons (BAPS) of a well neonate with Hirschsprung's disease (HD). Replies were received from 63 (84%) of the 75 consultant surgeons who operate on neonates with gastrointestinal problems. Twenty-six surgeons (41%) would aim to perform a primary pull through without colostomy, and 37 (51%) would stage the pull through, with stoma formation in the neonatal period. Timing of definitive surgery varied as did the choice of procedure (Soave 24%, Swenson 8%, Duhamel 62%, other 6%), but there was no evidence that surgical experience influenced the choice of operation. Most surgeons see 4-5 new cases of Hirschsprung's disease per year. This study shows great variation in operative procedures for the same clinical condition, and indicates the need for further audit.