الفهرس 
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Abstract
Hirschsprung disease is a common cause of neonatal and children intestinal obstruction. Diagnosis require, history taking, examination, contrast enema study and rectal biopsy.
Traditionally, treatment of Hirschsprung disease (HD) had consisted of a colostomy at diagnosis followed by one of a variety of pull-through procedures as a multistage approach.
one stage Soave (endorectal) Trans-anal pull-through is now favored in many centers worldwide with results as favorable as multistaged procedures, and there may be a cost advantage as well. As this approach is not including any intraabdominal or pelvic dissection, and doesn’t require laparotomy or laparoscopy, and has good cosmetic results.
Problems with residual aganglionic (the muscular cuff) tissues in Soave procedure, and concern of recurrence of symptoms of Hirschsprung with growth of these residual tissues as the patient grow, made some centers to try a trans-anal Swenson approach, with the label of the era (Swenson Revisited Transanally)
Our results confirmed that the Swenson Trans-anal pull-through, is a safe and effective alternative for treatment of HD, with comparable results to the more established Soave procedure, also with shorter operative time, without increased incidence of urological problems, or intraoperative injury of surrounding vital structures. The technique can even be easier than Soave procedure.
The modification of the Swenson procedure to a transanal dissection as opposed to an intraabdominal dissection has the potential advantage of avoiding injury to intrapelvic structures, preserving the sphincters, blood supply and innervation; therefore, urinary and fecal continence are less likely to be offended. But to assess this longer period of follow up is needed.
Unfortunately, we could not assess the functional outcome as sexual function and continence (which are very important parameters) in this study because of the short period of follow up and the young age of the patients. so further assessment of the Swenson technique with larger number of patients and longer period of follow up is recommended.