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J Pediatr Surg. 2014 May;49(5):774-6. doi: 10.1016/j.jpedsurg.2014.02.073. Epub 2014 Feb 22.

Transanal pullthrough for Hirschsprung disease: matched case-control comparison of Soave and Swenson techniques.

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Division of Pediatric Surgery, Children's Hospital of Eastern Ontario, University of Ottawa. Electronic address:
Division of Pediatric Surgery, Children's Hospital of Eastern Ontario, University of Ottawa.
Division of General and Thoracic Surgery, The Hospital for Sick Children, Department of Surgery, University of Toronto.



Both the Swenson and the Soave procedures have been adapted to a transanal approach. The purpose of this study was to compare outcomes following the transanal Swenson and Soave procedures using a matched case control analysis.


A retrospective chart review was performed to identify all transanal Soave and Swenson pullthroughs done at 2 tertiary care children's hospitals between 2000 and 2010. Patients were matched for gestational age, mean weight at time of the operation, level of aganglionosis, and presence of co-morbidities. Student's t-test and chi-squared analysis were performed.


Fifty-four patients (Soave 27, Swenson 27) had adequate data for matching and analysis. Mean follow-up was 4±1.6 years and 3.2 ±2.7 years for the Soave and Swenson groups, respectively. No significant differences in mean operating time (Soave:191±55, Swenson:167±61 min, p=0.6), overall hospital stay (6±4 vs 7.8±5 days, p=0.7), and number with intra-operative complications (3 vs 4, p=1.0), post-operative obstructive symptoms (6 vs 9, p=0.5), enterocolitis episodes (4 vs 4, p=1.0), or fecal incontinence (0 vs 2, p=0.4) were noted.


After controlling for potential confounders, there were no significant differences in the short and intermediate term outcome between transanal Soave and transanal Swenson pullthrough procedures.


Children; Hirschsprung disease; Operative repair; Soave; Swenson; Transanal

[Indexed for MEDLINE]

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