Clinical Study of Hirschsprung Disease and Long- Term Outcome of Duhamel?s Pull-Through

SK Sabir Ahmed, Arindam Ghosh, Sujay Pal, Rishavdeb Patra

Abstract: Background: Duhamel?s Pull Through (DP)is one of the established surgeries described for Hirschsprung?s disease (HD). It is the most common procedure for HD at our hospital. Objective: Clinical Study and analysis of the results, complications, and follow-up of DP in patients of HD at a tertiary care centre. Materials and Methods: 29 patients has been selected. Medical records of 29 patients who had undergone DP for HD at a tertiary care institute were obtained. These patients were followed in the outpatient?s department to see any complications. This data were used to critically analyse this operative method and its results. Results: Ureter injury (3%), burst abdomen (7%), fecal fistulae (3%), perianal excoriation (3%), parastomal hernia (3%), Soiling (38%), bleeding PR (3%), fecal incontinence (9%), loose motion (35%), urinary incontinence (3%) and constipation (12%) were some complications observed in this study. Most of these complications were successfully managed. Conclusions: Staged DP done after an initial colostomy has good results and is being done in all cases of megacolon with constipation. Post-operative complications can usually be managed successfully leading to a significant improvement in the quality of life.

Keywords: Duhamel's procedure, Hirschsprung's disease