pediatrics
Hirschsprung Disease
Treatment of Hirschsprung Disease
Surgical repair Treatment of Hirschsprung disease is surgical repair by bringing normally innervated bowel to the anus with preservation of the anal sphincters. In the neonate, this had typically been a 2-stage procedure beginning with a colostomy proximal to the aganglionic segment to decompress the colon. Then the neonate was allowed to grow before the 2nd stage of the procedure, in which the entire aganglionic portion of the colon was resected and a pull-through procedure was done. However, many centers now do a 1-stage procedure in the neonatal period for short-segment disease. Results using laparoscopic technique are similar to those of the open method and are associated with shorter hospitalizations, earlier initiation of feeding, and less pain. After definitive repair, the prognosis is good, although a number of infants have chronic dysmotility with constipation, obstructive problems, or both. 