Anorectal motility after rectal myectomy in patients with Hirschsprung's disease.
Anorectal manometric studies were performed 42 times in 13 patients with rectal myectomy and 137 times in 49 cases treated by the PTCF method. The resting pressure of the anal canal was found to be lowered just after the operation and remained at levels lower than those in normal controls and in patients with rectal myectomy. This fact was attributed to the resection of the muscle layer in the anal canal. On the other hand, the resting pressure of the anal canal in patients undergoing the PTCF method decreased after the operation and recovered to normal levels within 3 years after the operation. This finding correlates with the clinical condition of bowel habits. The resting pressure of the rectum elevated and remained high for more than 3 years in patients with rectal myectomy. This finding can be explained by the high tonus of the rectum oral to the aganglionic bowel which was left after rectal myectomy. The resting pressure of the rectum in patients treated by the PTCF method elevated just after the operation. It was lowered, however, to the normal level within about 3 years after the operation. Regarding the data of basal rhythmic waves, no significant change was observed Regarding the data of basal rhythmic waves, no significant change was observed in comparison with normal controls. The rectoanal reflex was observed only twice out of the 42 studies in patients with rectal myectomy and in nine of 137 studies in patients treated by the PTCF method. There was no relationship between the presence of reflex and clinical bowel habits.
Ohi
R
R
Division of Pediatric Surgery, Tohoku University School of Medicine, Sendai, Japan.
Komatsu
K
K
D000293:Adolescent; D001003:Anal Canal / Q000502:physiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005769:Gastrointestinal Motility; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008365:Manometry; D009130:Muscle, Smooth / Q000502:physiology / Q000601:surgery; D012007:Rectum / Q000502:physiology / Q000601:surgery*; D012018:Reflex / Q000502:physiology