To determine if rectal myectomy is an effective treatment for a specific group of patients with Hirschsprung's disease.
Retrospective series with follow-up of 6 to 132 months (mean follow-up, 37.1 months).
Fourteen children aged 2 to 14 years with chronic constipation and nondiagnostic barium enema contrast study findings.
Posterior rectal myectomy.
Main Outcome Measures:
Laxative use, frequency of stools, incidence of soiling or incontinence, and patient's assessment of improvement.
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.
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)
Sawin R, Hatch E, Schaller R, Tapper D. Limited Surgery for Lower-Segment Hirschsprung's Disease. Arch Surg. 1994;129(9):920-925. doi:10.1001/archsurg.1994.01420330034008