Adult Hirschsprung's disease

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Abstract
Fifty adult patients with Hirschsprung''s disease were operated on at the Mayo Clinic, in [Rochester, Minnesota] between 1950-1978. Six different operations were used. Of the 3 patients treated by the Soave endorectal pull-through procedure, 2 suffered anastomotic leaks and required diverting colostomies; all 3 had excellent long-term results. All 4 patients who underwent the Duhamel procedure had excellent results, with only 1 minor complication. Of the 17 patients undergoing the Swenson procedure, 6 had major postoperative complications, including 2 with impotence; 3 (17.6%) patients were considered treatment failures. Among the 13 patients who underwent rectal myectomy, there was 1 minor complication, although 5 (38.5%) had unsatisfactory results. Six patients had anterior resection, 1 of whom died of generalized peritonitis from an anastomotic leak and 1 patient suffered recurrent megacolon that required resection of an additional segment of colon. Four of the 5 survivors had excellent results. Of the 7 patients who underwent left hemicolectomy or total abdominal colectomy, 2 had serious postoperative complications and 2 required resection of an additional segment of colon because of recurrent symptoms. All 7 patients eventually had excellent results.

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