Sixty-four patients had Hirschsprung's disease. A Swenson, Duhamel, or endorectal pull-through was performed on 56 patients. Seven neonatal deaths occurred prior to, and four deaths followed definitive procedures. In 17 of 46 patients, significant complications followed diverting enterostomies.
The Duhamel procedure had the highest incidence of complications. Recurrent colonic spur was the predominant objection to this procedure. Complications following the Swenson pull-through and the endorectal pull-through were comparable.
Endorectal pull-through had the lowest incidence of complications. Leak, stenosis, and enterocolitis were less severe and more easily treated in this group. The general postoperative course and long-term results of the endorectal pull-through were superior to those following the other pull-throughs, and is now the chosen procedure at the Children's Hospital of Buffalo.