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Jay L. Grosfeld, MD; Thomas V. N. Ballantine, MD; John F. Csicsko, MD

Arch Surg. 1978;113(4):454-460.

Abstract
• Eighty-nine patients with Hirschsprung's disease were treated from 1972 to 1977. Of the patients, 70 were boys, 85 were the result of full-term pregnancy, and four had Down's syndrome. There were 23 children, 32 infants, and 34 neonates including seven (20%) with enterocolitis. Early mortality was 8.8% in neonates and 3% in infants. After initial diversion (colostomy or enterostomy), 66 patients had "classic" (ten), modified (52), or "long" (four) Duhamel pull-through procedures at age 1 year. Operative mortality was zero. Three late deaths occurred; two of them were mongols.

Fecaloma occurred in eight of ten classic cases that required revision. Postoperative enterocolitis occurred in three of four long procedures done for total colonic aganglionosis. The modified Duhamel procedure was associated with a low complication rate and good function. There were no instances of anastomotic leak, anal stricture, or genitourinary problems. These data indicate that the modified Duhamel operation is a highly acceptable procedure in the management of Hirschsprung's disease.

(Arch Surg 113:454-460, 1978)

Author Affiliations
From the Section of Pediatric Surgery, Indiana University School of Medicine, and the James Whitcomb Riley Hospital for Children, Indianapolis.

Footnotes
Accepted for publication Dec 12, 1977.

Read before the 85th annual meeting of the Western Surgical Association, Las Vegas, Nov 15, 1977.

Reprint requests to Surgeon-in-Chief, James Whitcomb Riley Hospital for Children, 1100 W Michigan St, Indianapolis, IN 46202 (Dr Grosfeld).

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