Surgical Approach for the Treatment of Hirschsprung Disease Using the Swenson Technique (SMILES)
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: transanal or laparoscopy assisted Swenson coloanal pullthrough.
- Who it may be relevant to
- Registry conditions: Hirschsprung Disease. Basic parameters: up to 16 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
A Bicenter Retrospective Comparative Study of the Surgical Approach for the Treatment of Hirschsprung Disease Using the Swenson Technique
Overview
Hirschsprung disease (HD) is a rare congenital disorder of the enteric nervous system, affecting approximately 1 in 5,000 live births. It is characterized by the absence of ganglion cells in the distal colon, leading to functional intestinal obstruction due to impaired peristalsis. Surgical treatment consists of resection of the aganglionic segment-most commonly rectosigmoid-followed by a colo-rectal, colo-anal, or ileo-anal anastomosis. Among colo-anal pull-through procedures, the Swenson technique was historically performed through an exclusively transanal approach, which carries a risk of sphincter injury correlated with operative duration. More recently, combined laparoscopic and transanal approaches have been developed to reduce this risk, although they may be associated with higher overall complication and reoperation rates. The Swenson procedure can be performed using a single-port laparoscopic approach, a technique that is sparsely described in the literature and rarely practiced in France. Single-port laparoscopy represents an emerging surgical technique that, despite increased technical complexity for surgeons, may further enhance postoperative recovery and cosmetic outcomes compared to conventional multiport laparoscopy. The objective of this study is to describe the outcomes of single-port laparoscopic Swenson pull-through in children with Hirschsprung disease and to compare them with outcomes obtained using more conventional approaches, namely exclusive transanal surgery or combined multiport laparoscopic and transanal approaches.
Interventions
- Procedure transanal or laparoscopy assisted Swenson coloanal pullthrough
TA-Swenson consist of total trananal endorectal pullthrough after a short submucosal dissection of the last part of the rectum. Laparoscopy-assisted Swenson pull-through consists of laparoscopic mobilization of the aganglionic colon with intraoperative level confirmation, followed by a transanal resection of the aganglionic segment and a primary coloanal anastomosis
Primary outcome measures
- To compare the short-term effectiveness of different surgical laparoscopic approaches used for the Swenson technique. [Time frame: From surgery to 12 months postoperatively]
Secondary outcome measures (5)
- To compare intraoperativensurgical efficiency according to surgical approach [Time frame: During surgery (day 0)]
- To compare immediate postoperative recovery [Time frame: At hospital discharge (average 5 days)]
- Short-term complications [Time frame: From hospital discharge to 30 days after surgery]
- Long-term complications [Time frame: From 31 days after surgery up to the last clinical follow-up visit (mean follow-up: 5.5 years)]
- Long-term continence outcomes [Time frame: Assessed after toilet training age (≥3-4 years old) and up to the last clinical follow-up visit (mean follow-up: 5.5 years)]
Eligibility criteria
Inclusion criteria
- Children under 16 years of age
- Diagnosis of Hirschsprung disease confirmed by initial rectal biopsy and postoperative pathological examination
- Primary Swenson coloanal pull-through performed at Angers or Caen University Hospital between January 1, 2010 and June 30, 2025
Exclusion criteria
- Parental or legal guardian opposition to the use of medical data for research purposes
- Hirschsprung disease treated with other surgical techniques (Duhamel, Soave, De La Torre, TERPT)
- Patients operated on in another hospital
- Patients who underwent rectosigmoid resection for causes of constipation other than Hirschsprung disease
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT07468565 · 49RC25_0501