STUDY OF OUTCOME AND COMPLICATIONS OF ANORECTAL MYECTOMY IN CHILDREN WITH ULTRASHORT SEGMENT HIRSCHSPRUNG’S DISEASE

Autor: J. Ahmadi, B. Ashjaei, M. Kalantari, H. Nahvi, A. Ebrahimsoltani, F. Nejat, M. Joodi, M. Vali V. Mehrabi
Jazyk: angličtina
Rok vydání: 2006
Předmět:
Zdroj: Acta Medica Iranica, Vol 44, Iss 4, Pp 256-258 (2006)
Druh dokumentu: article
ISSN: 0044-6025
Popis: The term ultra short is not clearly defined in ultrashort-segment Hirschsprung’s disease. The limited extent of the ultrashort-segment Hirschsprung’s disease allows for treatment with extended sphincteromyectomy. In anal sphincter achalasia, anal sphincter dilatation under general anesthesia may be sufficient to treat the condition; in cases with persistent constipation, sphincteromyectomy is indicated. Some investigators believe that the term ultrashort-segment Hirschsprung’s disease and anorectal achalasia are the same. Our study was performed to define the efficacy of transanal anorectal ‎myectomy and digital dilation under general anesthesia in children with ultra short-segment Hirschsprung’s disease and internal anal sphincter achalasia. A total of 87 patients were included in our study. Among these, 15 cases (17.24%) were female and 72 (82.76%) were male. In 12 patients (13.79%), the muscle strip had normal ganglion cells in both distal and proximal ends (group A). In 10 patients (11.49%), there was not any ganglion cell in both distal and proximal ends of muscle strip (group B). In 65 patients (74.71%), there were normal ganglion cells in proximal end with no ganglion cell in distal end of the muscle strip (group C). ‎There was no meaningful differences between group A, B and C in their outcome and partially or complete response to anorectal myectomy. We recommend the term “sluggish rectum” for these patients instead of ultrashort-segment Hirschsprung’s disease or internal anal sphincter achalasia that causes ambiguity in diagnosis and treatment of these cases.
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