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Hirschsprung's disease: present UK practice

S N Huddart1

  • 1Department of Paediatric Surgery, University Hospital of Wales, Cardiff.

Annals of the Royal College of Surgeons of England
|May 14, 1998
PubMed
Summary
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Management of Hirschsprung

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Neonatal Care

Background:

  • Hirschsprung's disease (HD) is a congenital condition affecting the large intestine.
  • Management strategies for neonates with HD vary among surgeons.
  • Standardization of care is needed for better patient outcomes.

Purpose of the Study:

  • To assess the current management practices for well neonates with Hirschsprung's disease.
  • To identify variations in surgical approaches among consultant members of the British Association of Paediatric Surgeons (BAPS).

Main Methods:

  • A postal survey was distributed to consultant surgeons within BAPS who operate on neonates with gastrointestinal problems.
  • The survey collected data on surgical management preferences, including primary pull-through versus staged procedures and specific surgical techniques.

Related Experiment Videos

  • Response rate was 84% (63 out of 75 surgeons).

    • Main Results:

    • Significant variation exists in the surgical management of Hirschsprung's disease.
    • 41% of surgeons favored primary pull-through without colostomy, while 51% opted for a staged approach with neonatal stoma formation.
    • The Duhamel procedure was most common (62%), followed by Soave (24%) and Swenson (8%). Surgical experience did not influence technique choice.

    Conclusions:

    • There is considerable heterogeneity in the surgical treatment of Hirschsprung's disease in neonates.
    • The findings highlight a need for further audit and potential guideline development to standardize care.
    • Varied approaches may impact long-term outcomes and require further investigation.