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

Background: 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. Methods: 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 comorbidities. Student's t-test and chi-squared analysis were performed. Results: 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 +/- 4vs7.8 +/- 5 days, p = 0.7), and number with intra-operative complications (3 vs 4, p = 1.0), postoperative 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. Conclusion: 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. (C) 2014 Elsevier Inc. All rights reserved.