Role of anorectal myectomy after failed endorectal pull-through in Hirschsprung's disease

Thirty-seven patients with Hirschsprung's disease (HD) underwent endorectal pull-through (ERPT). Six children had signs and symptoms similar to those of their preoperative state, and their conditions did not respond to conservative therapy. Anorectal manometry showed high anal canal pressure in...

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Bibliographic Details
Published inJournal of pediatric surgery Vol. 29; no. 10; pp. 1307 - 1309
Main Authors Banani, S.Abbas, Forootan, Hamid
Format Journal Article
LanguageEnglish
Published Philadelphia, PA Elsevier Inc 01.10.1994
Elsevier
Subjects
Adolescent
Anal Canal - surgery
Anastomosis, Surgical
Biological and medical sciences
Child
Child, Preschool
Constipation - etiology
Constipation - surgery
Female
Gastroenterology. Liver. Pancreas. Abdomen
Hirschsprung Disease - surgery
Humans
Infant
Male
Medical sciences
Other diseases. Semiology
Postoperative Complications - surgery
Rectum - surgery
Reoperation
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Treatment Failure
Hirschsprung's disease
endorectal pull-through
anorectal myectomy
Human
Postoperative
Reoperation
Nervous system diseases
Congenital
Aganglionosis
Infant
Anorectal
Congenital disease
Treatment
Malformation
Surgery
Megacolon
Diseases of the autonomic nervous system
Digestive diseases
Intestinal disease
Constipation
Child
Myectomy
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Summary:Thirty-seven patients with Hirschsprung's disease (HD) underwent endorectal pull-through (ERPT). Six children had signs and symptoms similar to those of their preoperative state, and their conditions did not respond to conservative therapy. Anorectal manometry showed high anal canal pressure in these patients. Anorectal myectomy (ARM), which included posterior rectal myectomy with partial internal sphincterotomy, was performed 6 to 55 months after ERPT. Five patients had marked improvement, and one had a partial response. Anal canal pressure was reduced significantly in all six patients. ARM is recommended after ERPT if constipation, abdominal distension, or repeated enterocolitis, unresponsive to conservative therapy, occurs. ARM should be performed before the patient is considered a candidate for a secondary pull-through operation.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0022-3468
1531-5037
DOI:10.1016/0022-3468(94)90102-3