Surgical Correction of Hirschsprung's Disease in Children Using the Soave-Boley Technique with Manual Colorectal Anastomosis


Surgical Treatment
Hirschsprung's Disease

How to Cite

Kurtash, O. (2020). Surgical Correction of Hirschsprung’s Disease in Children Using the Soave-Boley Technique with Manual Colorectal Anastomosis. Galician Medical Journal, 27(4), E2020410.


Introduction. Current trends in surgical treatment of Hirschsprung's disease are aimed at minimally invasive interventions. However, the experience of using Soave-Boley procedure in surgical treatment of Hirschsprung's disease in children of different ages is valuable in the arsenal of differentiated approach to the treatment of this pathology.

The objective of the research was to evaluate the results of surgical correction of Hirschsprung's disease in children using the Soave-Boley technique with manual colorectal anastomosis.

Materials and Methods. The analysis of surgical treatment of 1,187 children with different forms of Hirschsprung’s disease aged from birth to 18 years over the period 1980-2020 was conducted in the National Children's Specialized Hospital“ Okhmatdyt”. Surgical correction of Hirschsprung's disease using the Soave-Boley technique was performed in 597 children. Before surgery, 156 patients underwent the first stage of treatment that consisted in the creation of a protective colostomy; in 441 cases, this intervention was performed without an intestinal stoma; the benefits of the Soave-Boley technique were evaluated.

Results. All the patients survived. In 15 (2.51%) out of 597 children, in the early postoperative period, there were observed: retrocolic hematoma (n = 2), retrocolic abscess (n = 7), anastomotic leak (n = 2), adhesive intestinal obstruction (n = 3), intussusception (n = 1). Fourteen (2.36%) patients developed surgical complications in the long-term period: residual aganglionosis (n = 9), anastomotic stenosis (n = 4) and coloptosis. Repeated Soave-Boley operation with manual colorectal anastomosis was successfully performed in 26 (4.362%) patients after primary correction of Hirschsprung's disease using different methods. Periodic episodes of fecal smearing in the remote period in 45 (7.53%) children were eliminated by conservative treatment. The success of this technique is confirmed by a much lower number of early (2.51%) and late (2.36%) postoperative surgical complications, as compared to those after using other methods of open surgical correction - 17.52% and 16.35%, respectively.

Conclusions. Surgical correction of Hirschsprung's disease in children using the Soave-Boley technique with manual colorectal anastomosis allows better control over applying each suture, anatomical joining the edges of the bowel, and reducing trauma to the rectal mucosa, which ensures the high reliability of colorectal anastomosis; it is the most effective way of radical correcting Hirschsprung' s disease in children in an open way in one-stage or two-stage interventions, and this technique is the operation of choice for secondary surgical correction of Hirschsprung's disease.


Kryvchenia DYu, Prytula VP, Silchenko MI, Danshyn TI, Sitkovska SM, Matiiash OYa. Rezultaty likuvannia ditey z khvoroboiu Hirshprunha. Prohnozy ta shliakhy pokrashchennia. Paediatric Surgery. 2008;4:51-54.

Prytula VP, Silchenko MI, Hussaini SF, Kuzyk AS, Kurtash OO, Iskov AP. Transanal endorectal pull-through and resection of colon, as modern approach to the treatment of Hirschprung’s disease in chidren. Archive of Clinical Medicine. 2014;20(2):93-94.

Peng C-H, Chen Y-J, Pang W-B, Zhang T-C, Wang Z-M, Wu D-Y, et al. STROBE-anastomotic leakage after pull-through procedure for Hirschsprung disease. Medicine [Internet]. 2018 Nov;97(46):e13140. Available from:

Ekenze SO, Ngaikedi C, Obasi AA. Problems and Outcome of Hirschsprung’s Disease Presenting after 1 Year of Age in a Developing Country. World Journal of Surgery [Internet]. 2010 Oct 26;35(1):22–26. Available from:

Fernández Ibieta M, Sánchez Morote JM, Martínez Castaño I, Cabrejos Perotti K, Reyes Ríos P, Rojas Ticona J, et al. [Quality of life and long term results in Hirschsprung’s disease]. Cir Pediatr [Internet]. 2014 Jul;27(3):117–124. Available from:

Friedmacher F, Ure B, Lacher M, Gosemann J-H. Open Versus Transanal Pull-Through for Hirschsprung Disease: A Systematic Review of Long-Term Outcome. European Journal of Pediatric Surgery [Internet]. 2013 Apr 9;23(02):094–102. Available from:

Khademi G, Khazdouz M, Sezavar M, Imani B, Akhavan H, Babapour A. Clinical outcome and bowel function after surgical treatment in Hirschsprung′s disease. African Journal of Paediatric Surgery [Internet]. 2015;12(2):143. Available from:

Langer JC. Hirschsprung disease. Current Opinion in Pediatrics [Internet]. 2013 Jun;25(3):368–374. Available from:

Lee J-T, Liu C, Tsai H-L, Chin T, Wei C-F. Successful Redo Pull-through for Hirschsprung’s Disease in a Haddad Syndrome Patient. Journal of the Chinese Medical Association [Internet]. 2010 Aug;73(8):438–440. Available from:

Levitt MA, Dickie B, Peña A. The Hirschsprungs patient who is soiling after what was considered a “successful” pull-through. Seminars in Pediatric Surgery [Internet]. 2012 Nov;21(4):344–353. Available from:

Yang L, Tang S, Cao G, Yang Y, Li S, Li S, et al. Transanal endorectal pull-through for Hirschsprung’s disease using long cuff dissection and short V-shaped partially resected cuff anastomosis: early and late outcomes. Pediatric Surgery International [Internet]. 2012 Mar 20;28(5):515–521. Available from:

Neuvonen MI, Kyrklund K, Rintala RJ, Pakarinen MP. Bowel Function and Quality of Life After Transanal Endorectal Pull-through for Hirschsprung Disease. Annals of Surgery [Internet]. 2017 Mar;265(3):622–629. Available from:

Prytula VP, Levytskyi AF, Silchenko MI, Hussaini SF, Godik OS, Kurtash OO, et al. Laparoscopic-assisted transanal endorectal pull-through of colon for treatment of Hirschsprung's disease in children. Standardy Medyczne-Problemy Chirurgii Dziecięcej. 2016;6(1):109.

Sheng Q, Lv Z, Xiao X. Re-operation for Hirschsprung’s disease: experience in 24 patients from China. Pediatric Surgery International [Internet]. 2012 Feb 23;28(5):501–506. Available from:

Tabbers MM, DiLorenzo C, Berger MY, Faure C, Langendam MW, Nurko S, et al. Evaluation and Treatment of Functional Constipation in Infants and Children. Journal of Pediatric Gastroenterology and Nutrition [Internet]. 2014 Feb;58(2):265–281. Available from:

Mahler T, Dassonville M, Truong D, Robert A, Goyens P, Steyaert H, et al. Long-Term Outcomes and Quality of Life in Patients after Soave Pull-Through Operation for Hirschsprung’s Disease: An Observational Retrospective Study. European Journal of Pediatric Surgery [Internet]. 2017 Jul 24;28(05):445–454. Available from:

Wilkinson DJ, Edgar DH, Kenny SE. Future therapies for Hirschsprung’s disease. Seminars in Pediatric Surgery [Internet]. 2012 Nov;21(4):364–370. Available from:

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