Objective To compare postoperative complic at ions and defecation functions between laparoscopic pull-through heart-shape colo proctectomy (LHSC) and open pull-through surgery in the treatment of Hirchsprung 's disease (HD). Methods A total of 57 children with HD were g iven LHSC from August 1999 to November 2003. Among them, 54 children were follow ed for a mean of 2.8 years (range, 6 months ~ 4.8 years). The operation time, co mplications, defecation functions, and hospitalization costs of these patients w ere analyzed. And the data of the 54 patients (Laparoscopic Group) were compared with those from other 48 patients (Open Group) who had undergone open pull-thro ugh surgery before August 1999. Results The operation time was longer in the Laparoscopic Group(169?59 min) than in the Open Group(138?43 mi n)(t=2.903,P=0.005). The total hospitalization costs of the Laparoscopic Group (12 030?1 050 yuan) was significantly higher than that of the Open G roup (10 500?1 500 yuan) (t=6.019,P=0.000). There were no statisti cal differences in the rate of postoperative complications between the two group s (?~2=2.86,P=0.091), but less wound infections and adhesive ileus and more urinary retention were seen in the Laparoscopic Group as compared with the Open Group. In the Laparoscopic Group, the rate of anorectal reflex recover y was 55.6%, the anorectal angle was 83.4??10.4?, and the incidence of abnorm al defecation, 11.1% (constipation and faecal contamination respectively account ed for 50%), all of which were similar to those in the Open Group. No significan t differences were found in the anorectal resting pressure and the length of ana l high-pressure zone between the two groups (t=-0.979, P=0.334; t=-0.234, P=0.816). Conclusions LHSC technique is a safe and effectiv e method for Hirchsprung's disease, with postoperative advantages of quick reco very, few complications, and defecation functions similar to open surgery.