A Retrospective Study Of 217 Cases Of Hirschsprung's Disease Undergoing Modified Duhamel Radical Operation

Background: The congenital megacolon is a frequent kind of pediatric disease which usually caused intestinal obstruction. It is also named hischsprung's disease (HD) and the incidence of HD is about 20% of intestinal obstruction in the newborn babies. The pathological characteristic of HD is that the sigmoid flexure and rectum muscles are lack of ganglion cells which could caused paralysis of colon and rectum. So this disease is called "non-ganglion syndrome" either. It is more and more payed attention by pediatric doctors because the morbitidy of HD has gradually increased in recent years. The incidence of HD is about 1/2000-5000, and the morbitidy of HD is much higher in male patientsthan that in female ones, the ratio is about 4:1.Objective: To assess the effects of HD undergoing modified Duhamel operation and Soave operation through a retrospective study in order to select the most effective treatment for the HD patients.Methods: 217 cases of HD padtients undergoing modified Duhamel operation and 40 cases of HD padtients undergoing Soave operation from 1989 to 2003 in the First Affliated Hospital of Zhengzhou University were collected.To assess the complications of the HD patients postoperatively: record the infection of the lung and wound, colon contract, constipation,anastomotic leakage and retention etc. The data was counted by X test through the SPSS 10.0 software.To assess the anorectal function postoperatively: measure the pressure difference in rectum and earthen pipe, the length in high pressure area of the angle of earthen pipe and rectum to deal. The data was counted by /test through the SPSS 10.0 software.Results: Modified Duhamel operation had less early and late complications than that of Soave operation. 215 cases of HD were cured without anastomotic narrow or leakage and had good late defecation. The rate of early complications was 9%, and the cured rate of HD was 92% which undergoing modified Duhamel operation. The rate of early complications was 22%, and the cured rate of HD was 88% whichundergoing Soave operation.Conclusions: ㏕he modified Duhamel operation is suitable to treat the patients of HD because of its simple operations, little trauma, few complications postoperatively, good anorectal function and high life quality.(l)The Soave operation is unsuitable to treat the patients of HD because of its complex operations, much trauma, many complications postoperatively, bad anorectal function and low life quality contrast to the modified Duhamel operation.(3)The modified Duhamel operation is more suitable for the patients of HD than the Soave operation.