Adopting the Swenson-like technique for patients with Hirschsprung disease in Vietnam

PURPOSE: To evaluate outcomes of adopting the Swenson-like technique in transanal pull-through for Hirschsprung disease (HD) at a children’s institution in Southeast Asia. METHODS: A retrospective chart review was performed over 42 months at a safety-net pediatric hospital in Vietnam. RESULTS: From January 2019 to June 2022, the Swenson-like technique was implemented and performed on 139 patients (115 male, 24 female, mean age 6.4 ± 11.96 months). There were 123 transanal-only resections, 5 transanal plus laparoscopic, and 11 transanal plus laparotomy. The mean operative time was 70.9 ± 43.6 min. The average length of the resected specimen was 18.8 ± 10.9 cm. No urethral or vaginal injuries occurred. Postoperative complications included 1 anastomotic leak (0.7%), 4 anastomotic stenoses (2.8%), and 2 perianal abscesses in the setting of recurrent enterocolitis (1.4%). With a mean follow-up of 26 ± 11.9 months (range 3–48 months), there were 25 enterocolitis cases (17.9%), 45 patients with constipation (32.3%), 1 episode of fecal incontinence lasting longer than 6 months (0.7%), and 1 rectal-vestibular fistula noted one year postoperatively (0.7%). There were no deaths. CONCLUSION: The Swenson-like technique in transanal pull-through for Hirschsprung's disease was safely adopted at our institution. The results show that applying this technique uniformly in a single institution led to excellent outcomes.