Surgical Treatment Outcomes for Idiopathic Chronic Megacolon and Megarectum

• Published in: Nippon Daicho Komonbyo Gakkai Zasshi Vol. 76; no. 8; pp. 509 - 515
• Main Authors: Matsumoto, Tomoko, Noake, Toshihiro, Ozasa, Hiroyuki, Irie, Tomoko, Tamaoki, Yuuka, Sakakibara, Yuuka, Shirouzu, Yoshimasa, Araki, Yasumi
• Format: Journal Article
• Language: Japanese; English
• Published: The Japan Society of Coloproctology 2023
• Subjects: anorectal manometry; colonic transit study; defecography; idiopathic chronic megacolon; rectoanal reflex
• ISSN: 0047-1801; 1882-9619
• DOI: 10.3862/jcoloproctology.76.509

Idiopathic chronic megacolon syndrome is a condition in which the large intestine is pathologically dilated despite the absence of a mechanical obstruction of the large intestine and the absence of an underlying disease or evidence that this condition may have been caused by the patient's medication history. Medical treatment is preferred for this condition, but if it is inadequate, surgical treatment may be required. Subtotal colectomy with ileorectostomy is the surgical treatment generally performed, but only removing the dilated intestine frequently results in dilation of the residual colon and some patients experience defecation disorder due to postoperative pelvic perineal dysfunctions.For surgical treatment, it is important to understand the pathology and to diagnose the scope of the lesion. Our hospital uses a colonic transit study with radiopaque markers to determine the range of resection. We also examine the results of defecography and anorectal manometry, and look at the patient's background to determine the optimal reconstruction method.The short-term and long-term results of the seven surgical cases we experienced at our hospital were good, and both the bowel movements and abdominal symptoms improved after surgery.