This study evaluated the outcome of

This study evaluated the outcome of the original Swenson operation for the treatment of HD in Nigerian children. Since Swenson described his original operation in 1948, there have been several modifications of techniques. Currently, there appears to be a shift towards transanal pullthrough as this is associated with less morbidity than open surgery. However, the choice of technique is still influenced by the training of the surgeon and the available resources and the presentation of the patient. At our hospital we have been using the open Swenson technique on all our patients with HD.

The results of this study suggest that the original Swenson operation still has a role to play in the management of HD in children, especially in our environment. The majority of our patients had a good postoperative outcome both in the short and medium term. Normal continence and regular bowel emptying is the primary goal in the surgery for HD. The dreaded possibility of urinary and faecal incontinency which led to several modifications of the technique did not surface in our patients. Continence has been generally satisfactory in most patients in this series. The incidence of faecal incontinence varies from less than 1% to as high as 32.7%.[12-14] Although we do not have facilities such as anorectal manometry for measuring sphincter function in these patients clinical history and examination revealed that most of our patients are continent. Three of the patients complained of soiling following surgery. In two of them there was just minor soiling which improved over time while one had major soiling mainly at night. None of the patients in our series developed urinary incontinence. Strict adherence to operative technique will avert this possibility in majority of the patients.

The anastomotic leak rate in this series was 6.1% which was comparable to that (5.6%) reported by Sherman et al., in larger series.[15] These leaks occurred in the initial phase of this study when a single-layered

Hasil (Bahasa Indonesia) 1:

Studi ini mengevaluasi hasil operasi Swenson asli untuk pengobatan HD pada anak-anak Nigeria. Karena Swenson digambarkan usahanya asli pada tahun 1948, ada beberapa modifikasi dari teknik. Saat ini, tampaknya ada pergeseran menuju transanal pullthrough karena ini dikaitkan dengan kurang morbiditas daripada bedah terbuka. Namun, pilihan teknik masih dipengaruhi oleh pelatihan dokter bedah dan sumber daya yang tersedia dan presentasi dari pasien. Di rumah sakit kami kita telah menggunakan teknik Swenson terbuka pada semua pasien kami dengan HD.The results of this study suggest that the original Swenson operation still has a role to play in the management of HD in children, especially in our environment. The majority of our patients had a good postoperative outcome both in the short and medium term. Normal continence and regular bowel emptying is the primary goal in the surgery for HD. The dreaded possibility of urinary and faecal incontinency which led to several modifications of the technique did not surface in our patients. Continence has been generally satisfactory in most patients in this series. The incidence of faecal incontinence varies from less than 1% to as high as 32.7%.[12-14] Although we do not have facilities such as anorectal manometry for measuring sphincter function in these patients clinical history and examination revealed that most of our patients are continent. Three of the patients complained of soiling following surgery. In two of them there was just minor soiling which improved over time while one had major soiling mainly at night. None of the patients in our series developed urinary incontinence. Strict adherence to operative technique will avert this possibility in majority of the patients. The anastomotic leak rate in this series was 6.1% which was comparable to that (5.6%) reported by Sherman et al., in larger series.[15] These leaks occurred in the initial phase of this study when a single-layered