ArticleBMC surgery2025
Outcomes of pull-through surgery among children with Hirschsprung's disease in Tanzania: a comparative study.
Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSurgical treatment of Hirschsprung disease (HD) has been performed through different techniques throughout the surgical history. All techniques evolve through a process of seeking optimal surgical outcomes. Our center has been using two main techniques to address the effects of Swenson and Rehbein's procedure. Reports are inconclusive regarding which technique provides optimal outcomes.
objectivesWe aimed to review and compare outcomes between Swenson's and Rehbein's procedures in a sub-Saharan African cohort.
methodsWe reviewed records of patients who underwent Pullthrough (PT) surgery at a tertiary hospital. The primary outcome of the study was bowel performance following surgery. Chi X
resultsData from 55 patients were reviewed, and 49 were analyzed. These patients underwent surgery between January 1, 2018, and July 31, 2020. Thirty-one patients underwent the Swenson procedure. A total of 75% of the patients who underwent Swenson's procedure had good bowel performance after surgery, whereas only 33% of those who underwent the Rehbein's procedure had good bowel performance (p = 0.01). The two procedures were comparable in terms of the amount of time needed. The complication rate was higher in Rehbein's procedure (77%, 14/19) than in Swenson's procedure (41%, 13/31). Constipation and residual aganglionotic segments were found mainly during Rehbein's procedure. CONCLUSION AND RECOMMENDATION: The Swenson pull-through technique demonstrated superior outcomes compared to the Rehbein procedure, with fewer postoperative complications and improved bowel function. These findings support the Swenson approach as the preferred surgical option in our setting. Nonetheless, prospective studies are recommended to validate these results and explore long-term functional outcomes.
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