September 1994

Limited Surgery for Lower-Segment Hirschsprung's Disease

Author Affiliations

From the Department of Surgery, Children's Hospital and Medical Center, University of Washington, Seattle.

Arch Surg. 1994;129(9):920-925. doi:10.1001/archsurg.1994.01420330034008

Objective:  To determine if rectal myectomy is an effective treatment for a specific group of patients with Hirschsprung's disease.

Design:  Retrospective series with follow-up of 6 to 132 months (mean follow-up, 37.1 months).

Setting:  Children's hospital.

Patients:  Fourteen children aged 2 to 14 years with chronic constipation and nondiagnostic barium enema contrast study findings.

Intervention:  Posterior rectal myectomy.

Main Outcome Measures:  Laxative use, frequency of stools, incidence of soiling or incontinence, and patient's assessment of improvement.

Results:  The conditions of all 14 patients improved regardless of the presence of ganglion cells in the myectomy specimen; there were six excellent, six good, and two fair assessments. Laxatives were used intermittently by seven of 14 patients. No patients complained of incontinence or soiling.

Conclusions:  Rectal myectomy is an effective, less-extensive operation that should be considered for older children with Hirschsprung's disease.(Arch Surg. 1994;129:920-925)