OUTCOMES OF ABDOMINOPERINEAL SWENSON PROCEDURE FOR HIRSCHSPRUNG’S DISEASE.

http://doi.org/10.46536/jpumhs/2023/13.03.4757

Abstract

OBJECTIVE: To share the outcomes of abdominoperineal Swenson procedure for Hirschsprung’s disease.

METHODS: A four-year retrospective observational study conducted from January, 2017 to January 2021

at PUMHS, Nawabshah after approval from ethical review board. We collected the medical records of 65

patients who were having Hirschsprung’s disease diagnosed clinically, radiologically and confirmed by

rectal biopsy. Abdominoperineal Swenson procedure performed in 65 patients by a single surgeon.

Variables analyzed were demographic, early post-operative and late post-operative complications,

dilatation compliance, and quality of life assessment. Initially the patients were followed weekly for

2months, once in a month for 6 months and after 3 months for a year. All statistical analyses were done by

using IBM SPSS 25 version. Categorical variables were expressed in frequency number and percentages.

Quantitative data were expressed as median or mean + standard deviation SD. RESULTS: There were 65

children, 48 boys and 17 girls M: F=2.8:1. The mean age of surgery was 2.43 years + 2.17 SD range 1-5

years. Out of 65 patients only 21 32.3% patients developed early post-operative complications wound

infection in 8 12.3%patients, wound dehiscence in 34.6% patients, transient neurogenic bladder in 3 4.6 %

patients, retraction of pulled segment in 4 6.1% patients, sepsis in 3 4.6% patients, death in 3 4.6% patients.

In late complications, 46.45% patient had stricture, 23.2% patient developed post op adhesions, and night

incontinence accidents seen in 5 8.1% patients. CONCLUSION: Swenson procedure is a good option to

deal with Hirschsprung’s disease in terms of low rate of complications. Fecal incontinence is the major

determinant of quality of life which should be addressed aggressively so child can live social life

comfortably