Limited surgery for lower-segment Hirschsprung's disease.
OBJECTIVE
To determine if rectal myectomy is an effective treatment for a specific group of patients with Hirschsprung's disease.


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


METHODS
Children's hospital.


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


METHODS
Posterior rectal myectomy.


METHODS
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.
Sawin
R
R
Department of Surgery, Children's Hospital and Medical Center, University of Washington, Seattle.
Hatch
E
E
Schaller
R
R
Tapper
D
D
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008722:Methods; D009132:Muscles / Q000601:surgery; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome