Short Communication
English
Faruk Elnagar, Emad Shawish, Habib Wershefani
General Surgical Unit, Tripoli Medical Centre, Tripoli, Libya
JMJ 2008,Vol.8, No.3:217-219
Abstract
Rehbein’s procedure is technically simple and in experienced hands can give good results for treating patients with Hirschsprung’s disease. Between January 1985 and Jan 1995, 284 patients, their age between 8 months and 14 year old, underwent operation for Hirschsprung’s disease (181 Male and 103 Females), all operations were carried out by one surgeon using Rehbein’s procedure which includes resection of the aganglionic segment of colon with a good margin of the dilated part in addition to elimination of the achalasia of the internal anal sphincter with either lateral sphincterotomy or digital anal dilatation. The results were evaluated according to patients’ or parents’ satisfaction with regard to the regularity of the bowel habit. 201 cases (70%) were completely satisfied with the result and there was no need for further management during subsequent follow-up. The rest of the cases (83 patients) were still complaining of constipation, of those 70 cases treated with repeated anal dilatations and 4 treated with lateral sphincterotomy. Satisfaction was achieved in 71 cases (26%) before discharge from the clinic. Re-operation was needed for 12 cases (4%) who remain constipated despite all of the above measures. There was no mortality in this study and we had very few surgical complications including: two patients (0.7%) who developed anastomotic leak which was treated successfully with conservative measures, four patients (1.5%) who developed wound infection and were treated with antibiotics and daily dressing for a few days. In conclusion an experienced surgeon in Rehbein’s procedure can achieve excellent results comparable with other modalities of treatment for Hirschsprung’s disease.
Keywords: Hirschsprung’s disease, Rehbein’s procedure, outcome.
Link/DOI: http://www.jmj.org.ly/PDF/autumn2008/217.pdf