INTERNAL ANAL SPHINCTER: IS IT PROPERLY MANAGED DURING RESECTIONAL SURGERY FOR HIRSCHSPRUNG'S DISEASE?

Document Type : Original Article

Authors

Department of Surgery, Faculty of Medicine, Mansoura University

Abstract

Aim: was to compare the technique and the postoperative continence state of Swenson's operation with its Wang's 
modification. 
Methods: 25 cases underwent a resectional surgery over 2.5 years. 13 underwent Wang's modification while Swenson's 
operation was performed for 12 cases. 
Mean age at operation was 16 months (2 months to 5 years). 
Results: Wang's operation had superior results than Swenson operation regarding postoperative soiling (P= 0.027) that 
occurred in 6 cases after Swenson operation and in only one case after Wang's operation while anastomotic leak occurred in one case of each group. Further, Wang's operation group had postoperative resting and squeeze pressures of 49.8±7.31 mmHg and 90.8±2.80 mmHg respectively; both are significantly higher than those recorded in Swenson operation group: 40.8±2.30, 78.0±7.21 respectively (P= 0.0001). 
Conclusion: Wang's modification of Swenson's operation represents a proper management of the internal anal sphincter during resectional surgery for HD through preservation of the anterior rectal wall and splitting its posterior wall with 
formation of heart shaped anastomosis.

Keywords

The Egyptian Journal of Surgery
Volume 24, Issue 4
October 2005
Pages 207-213

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