Modified Duhanmel procedure versus low anterior resection for Hirschsprung’s disease and its allied disorder in adults

Abstract:

Objective：To evaluate the clinical efficacy and safety of modified Duhamel procedure for Hirschsprung’s disease（HD） and Hirschsprung’s allied disorder（HAD） in adults. Methods：Clinical data of 29 adult patients with HD and HAD who underwent one-stage modified Duhamel procedure（D group，n=16） or low anterior resection（L group，n=13） between January 2001 and January 2012 were analyzed respectively. Results：All operations were one-stage procedure without death case. There was no significant difference in mean preoperative life quality score（（2.2±0.7） or （15.1±1.0）），operation time（（160±21） min） and incidences of postoperative complications between two groups（P ＞0.05）. However，there were less mean intraoperative blood loss（（54.4±23.7） ml，t=2.394，P=0.028），shorter mean postoperative hospital stay（（12.6±4.1） d，t=2.381，P=0.025） and higher postoperative life quality score（（4.4±1.4），t=2.090，P=0.046 and （17.9±1.2），t=2.224，P=0.035） in D group compared with those of L group. Of the six patients who were considered treatment failures with unsolved serious complications or reoperations，2 patients were from D group and 4 patients were from L group. Conclusions：Modified Duhamel procedure is safe and effective in the treatment of HD and HAD in adults.