Primary corrective operation without decompression in infants less thn three months of age with Hirschsprung's disease.

From Jan 1, 1965 to Nov 1, 1980, 155 infants with Hirschsprung's disease have been treated. All had confirmed aganglionosis at multiple rectal biopsies. From 1965 to 1969, 54 patients underwent a Swenson's procedure at an age ranging from 12 to 18 months after a preliminary colostomy. 13 patients died between colostomy and definitive operation. From 1969 to 1977, the delay in performing corrective operation after colostomy was shortened and the definitive procedure was done between 6 and 11 months of age in 69 patients. No fatality was observed but in 9 cases a perianal dermatitis lowered the quality of functional results. From 1977 to Nov 1, 1980, progress in immediate nursing and total parenteral nutrition made colostomy unnecessary in 19 neonates and infants with severe Hirschsprung's disease. The definitive surgical procedure (mainly Swenson's) was performed before 3 months of age. The postoperative results were excellent. After more than 4 years of follow-up for the first cases, the good secondary results, the quality o defecation, and the shortening of total hospital time, allow us to advocate this method in selected cases.