OBJECTIVE: To describe our exp
erience with Swenson's op
eration for Hirschsprung's disease done during the neonatal p
eriod. DESIGN: Retrospective study. SETTING: Univ
ersity department of paediatric surg
ery. SUBJECTS: 10 Neonates with Hirschsprung's disease. INTERVENTIONS: Rectosigmoidectomy and pull through (Swenson's op
eration), with cov
ering transv
erse colostomy. MAIN OUTCOME MEASURES: Mortality, morbidity, and continence. RESULTS: The median age at definitive op
eration was 25 days (range 15-35). Th
ere was one late death three weeks aft
er discharge from hospital of respiratory and cardiac failure. Two patients presented with caecal p
erforation and two with intestinal obstruction; in all four Hirschsprung's disease was diagnosed on frozen section, a transv
erse colostomy was done, and the Swenson's op
eration was done electively. The oth
er six w
ere diagnosed by barium enema examination and biopsy, and und
erwent total bowel irrigation followed by Swenson's op
eration and transv
erse colostomy. The colostomies w
ere closed three to four weeks lat
er. Th
ere w
ere no postop
erative complications. All nine surviving patients w
ere continent (3-4 stools/day), at a mean (SD) follow up of 21 (5) months. CONCLUSION: With the current high standards of anaesthesia and neonatal intensive care, and an exp
erienced surgeon, Swenson's op
eration for neonatal Hirschsprung's disease is safe and the procedure of choice for this condition.
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