The surgical correction of Hirschsprung's Disease in adults using the Modified Duhamel procedure.
- Author:
Marc Paul J. Lopez
;
Mayou Martin T. Tampo
;
Manuel Francisco T. Roxas
;
Armand C. Crisostomo
;
Hermogenes J. Monroy III
- Publication Type:Journal Article
- Keywords:
adult Hirschsprung’s disease;
colostomy;
Modified Duhamel procedure
- From:
Philippine Journal of Surgical Specialties
2020;75(2):123-131
- CountryPhilippines
- Language:English
-
Abstract:
BACKGROUND: Hirschsprung’s disease (HD) is rare in adults, since a
majority of cases are corrected in childhood.
OBJECTIVES:The authors describe the profile of patients with HD
who reached adulthood without having undergone corrective surgery.
Also, they describe the outcomes of a modified Duhamel procedure
in these patients, in terms of morbidity and mortality.
METHODS:This retrospective study, included patients 18 years old
and above, diagnosed with HD who reached adulthood without having
undergone definitive repair and managed surgically by the Division
of Colorectal Surgery, UP-PGH from January 1, 2004 to December
31, 2014. A review from the Department Surgical Database was used
and patients’ hospital records were used to fill out a Data Collection
Form. Descriptive statistics were used to summarize the data.
RESULTS: The 13 patients included in the study were diagnosed at
an average age of 16.6 (± 13.16) years. The mean age at the time of
definitive surgery was 23.46 (± 6.96) years. The M:F ratio was 5.5:1.
The most common presenting symptom was constipation (69.23%).
All had a prior proximal bowel diversion, with a transverse loop
colostomy (61.54%) being the most common. The transition zone
was located in the sigmoid in a third of patients. The mean time
from diagnosis to definitive surgery was 6.69 years. Eight (61.54%)
have since undergone stoma reversal. There was only one (7.69%)
morbidity, a superficial surgical site infection. No mortalities were
reported.
CONCLUSION:The modified Duhamel procedure is a safe definitive
surgical procedure for the adult patient with HD.
- Full text:The surgical correction of Hirschsprung's Disease.pdf
