Swenson Pull-Through
Pronunciation: SWEN-son pull-through
Classical surgical approach for Hirschsprung disease involving full-thickness rectal resection and primary anastomosis. Original definitive procedure.
Full Definition
The Swenson pull-through is the original and classical surgical technique for treating Hirschsprung disease, first described by Orvar Swenson in 1948. This procedure involves complete mobilization and resection of the aganglionic segment, including full-thickness removal of the aganglionic rectum down to the anal verge. The ganglionic colon is then pulled through and anastomosed to the anal canal just above the dentate line. While this technique provides excellent long-term functional results, it carries higher risks of complications including anastomotic leak, stricture, and potential damage to pelvic nerves. Modern modifications have reduced morbidity, but the procedure requires considerable technical expertise.
Usage
Usage note: Emphasize the full-thickness nature of the rectal resection when distinguishing from other techniques.
In Context
- "The Swenson pull-through was completed with a tension-free anastomosis 1 cm above the dentate line." — Operative report
- "Long-term continence rates following Swenson pull-through approach 95% in experienced centers." — Outcomes research paper