Background: congenital megacolon is still one of the most important disease occurred in children. Different surgical approaches were developed each with variety of complications. In the present article, we explained our experience with 420 patients with congenital megacolon undertook Swenson operation in a 20-year period, 1979-99.

Materials and Methods: All patients who have been pathologically diagnosed as congenital megacolon were entered. Initial data including sex, age, clinical manifestations, pathologic reports, accompanying diseases and early and late complications were analyzed. Then, patients were invited to survey the operation outcome such as bowel and bladder continence.

Results: The study population included 310 boys and 110 girls aged 3 days to 14 years. Early and late complications were reported in 24.3% and 24.8%, respectively (P<0.0001, P<0.001 respectively). Enterocolitis was reported in 12.6%.

Conclusion: Swenson approach is associated with satisfactory outcomes in patients with congenital megacolon.