The aim of this study is to review our clinical experience with patients with Hirschsprung's disease (HD) Medical records of 39 children who underwent definitive surgery for HD at Inha University Hospital from September 1996 to June 2008 were analyzed by age at presentation, sex, gestational age, birth weight, clinical presentation, diagnostic tools, level of aganglionosis, surgical procedures, postoperative complications, and postoperative bowel function. Twenty-five patients (64.1%) were males and 14 (35.9%) were females. Thirty patients (76.9%) were diagnosed and treated in the neonatal period. The transitional zone was at the rectosigmoid region in 89.7%. Twenty-seven patients (69%) were treated by preliminary colostomy or ileostomy. Twenty-four patients had the Duhamel operation, 6 patients anorectal myectomy, and 9 patients had transanal endorectal pull-through (TEP). Five of 9 patients who had the TEP procedure did laparoscopic assistance. Postoperatively, seventeen patients (83%) passed stool once or more times per day and 3 patients had stool soiling. This study demonstrated that the majority of the patients had good results. To determine which treatment is most effective comparative review by operation method would be required.

To estimate the normal anal canal pressure in neonates, anal manometry was performed in 46 normal babies less than 6 days of age. Twenty-eight of the subjects were boys and 18 girls. All the subjects passed meconium within 24 hours after birth. Birth weights were above 2.4 kg. There were no sexual differences in birth weight, birth height, gestational age, postnatal age, or Apgar score (p<0.05). The mean manometry values were; anal sphincter length 18.6± 3.9 mm, high pressure zone (HPZ) 9.2 ± 3.6 mm, vector volume 2027.2 ± 2440.7 mmHg2cm, maximum pressure 42.3 ± 17.4 mmHg, and position of the maximum pressure 6.0 ± 22.4 mm. Only the HPZ of boys was longer than those of girls (p=0.005). In squeezing state, HPZ and the position of maximun pressure were not changed from resting state. HPZ, vector volume, and maximum pressure in boys were higher than those in girls. As the birth weight increased, the anal sphincter length (p=0.001) and the HPZ increased (p=0.047). The resting pressures of the anal canal were evaluated in three portions; /23 upper portion, 12.8± 8.6mmHg, middle portion, 20.3 ± 10.8mmHg, and lower portion, 26.1 ± 12.9 mmHg. These normal values may serve as guidelines for the evaluation, diagnosis and treatment of neonatal anal diseases.