ABSTRACT
The aim of this study is to compare between the transanal pull-through and the open Soave technique in the surgical correction of neonatal Hirschsprung's disease as regards the results, feasibility, operative and immediate postoperative details. A prospective analysis of twenty neonates with Hirschsprung's disease admitted to the Pediatric Surgery Unit, Alexandria University from August 2002, till August 2003, was carried out. The twenty cases were classified randomly into two groups, ten in each. Group A underwent transanal pull-through, while group B underwent open Soave operation. The results showed that, in-group A, the mean operative time was 40 minutes [30-60], compared to 80 minutes in-group B. The mean length of hospital of stay was three days [2-5] in-group A, while in-group B it was 9 days [8-11]. Babies in-group A started oral feeding after a mean period of 1.5 day [1-2 days], whereas in-group B, it was 4 days [3-5]. Both groups recorded no bowel motion disturbance. Two cases required anal dilatation in-group B, in comparison to only one case in-group A. Neither major complications, nor mortality was observed
Conclusion: in selected cases, one stage pull-through operation can be safely done in neonatal Hirschsprung's disease. Transanal technique is superior to open Soave due to its simplicity, cost effectiveness, and less surgical morbidity