article · BMC Surgery
Hirschsprung disease requires surgical treatment, yet evidence has remained inconclusive regarding whether the Swenson or the Rehbein pull-through technique yields superior clinical results. A review of 49 paediatric patients operated on between 2018 and 2020 at a surgical centre compared the outcomes of these two methods. Patients treated with the Swenson procedure experienced substantially better postoperative bowel function, achieving a 75 percent success rate compared to 33 percent for those undergoing the Rehbein approach. Both techniques required similar operating times. However, complications occurred more frequently with the Rehbein procedure, affecting 77 percent of patients compared to 41 percent of those treated with the Swenson technique. Difficulties such as constipation and residual aganglionic segments were primarily observed after the Rehbein procedure, leading to the conclusion that the Swenson technique offers a preferable surgical approach in this setting.
Hirschsprung disease is a serious congenital condition requiring surgery to restore normal bowel function in children. Identifying the technique that delivers the fewest complications and the best recovery helps hospitals and paediatric surgical teams establish safer, standard clinical practices. This directly improves child recovery rates and lowers the risk of repeat procedures.
This research provides applied comparative clinical evidence directly relevant to paediatric surgeons, clinical directors, and hospital administrators reviewing surgical protocols. While it informs surgical decision-making and guideline standardisation immediately in hospital environments, the abstract does not indicate any product development, intellectual property, or commercial application pathway.
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BACKGROUND: Surgical treatment of Hirschsprung disease (HD) has been performed through different techniques throughout the surgical history. All techniques evolve through a process of seeking optimal surgical outcomes. Our center has been using two main techniques to address the effects of Swenson and Rehbein's procedure. Reports are inconclusive regarding which technique provides optimal outcomes. OBJECTIVES: We aimed to review and compare outcomes between Swenson's and Rehbein's procedures in a sub-Saharan African cohort. METHODS: and Fisher's exact tests were used. Logistic regression analysis was carried out to detect any associations among the outcomes. RESULTS: Data from 55 patients were reviewed, and 49 were analyzed. These patients underwent surgery between January 1, 2018, and July 31, 2020. Thirty-one patients underwent the Swenson procedure. A total of 75% of the patients who underwent Swenson's procedure had good bowel performance after surgery, whereas only 33% of those who underwent the Rehbein's procedure had good bowel performance (p = 0.01). The two procedures were comparable in terms of the amount of time needed. The complication rate was higher in Rehbein's procedure (77%, 14/19) than in Swenson's procedure (41%, 13/31). Constipation and residual aganglionotic segments were found mainly during Rehbein's procedure. CONCLUSION AND RECOMMENDATION: The Swenson pull-through technique demonstrated superior outcomes compared to the Rehbein procedure, with fewer postoperative complications and improved bowel function. These findings support the Swenson approach as the preferred surgical option in our setting. Nonetheless, prospective studies are recommended to validate these results and explore long-term functional outcomes.
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DOI: 10.1186/s12893-025-03369-8
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