Adopting the Swenson-like technique for patients with Hirschsprung disease in Vietnam
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In brief
In brief
This 42-month Vietnamese study of 139 pediatric patients demonstrates successful adoption of the Swenson-like transanal pull-through technique for Hirschsprung disease, with low complication rates (0.7% anastomotic leak, 2.8% stenosis) and no mortality. The technique proved safe and effective in a resource-limited setting, with most cases completed transanally without laparoscopic assistance.
Written by the GCMD Library team from the article.
Abstract
Purpose
To evaluate outcomes of adopting the Swenson-like technique in transanal pull-through for Hirschsprung disease (HD) at a children’s institution in Southeast Asia.
Methods
A retrospective chart review was performed over 42 months at a safety-net pediatric hospital in Vietnam.
Results
From January 2019 to June 2022, the Swenson-like technique was implemented and performed on 139 patients (115 male, 24 female, mean age 6.4 ± 11.96 months). There were 123 transanal-only resections, 5 transanal plus laparoscopic, and 11 transanal plus laparotomy. The mean operative time was 70.9 ± 43.6 min. The average length of the resected specimen was 18.8 ± 10.9 cm. No urethral or vaginal injuries occurred. Postoperative complications included 1 anastomotic leak (0.7%), 4 anastomotic stenoses (2.8%), and 2 perianal abscesses in the setting of recurrent enterocolitis (1.4%). With a mean follow-up of 26 ± 11.9 months (range 3–48 months), there were 25 enterocolitis cases (17.9%), 45 patients with constipation (32.3%), 1 episode of fecal incontinence lasting longer than 6 months (0.7%), and 1 rectal-vestibular fistula noted one year postoperatively (0.7%). There were no deaths.
Conclusion
The Swenson-like technique in transanal pull-through for Hirschsprung's disease was safely adopted at our institution. The results show that applying this technique uniformly in a single institution led to excellent outcomes.