Posterior sagittal resection for rectal aganglionosis: preliminary results of a new approach.
BACKGROUND
There is no general agreement about how patients who have short-segment Hirschsprung's disease should be treated.


METHODS
Ten patients with Hirschsprung's disease, seven with rectal and three with rectosigmoidal aganglionosis, were operated on through a posterior sagittal incision. In nine patients, a primary rectal resection and coloanal anastomosis was performed. In one patient, a longitudinal posterior myectomy of the rectum was performed as a primary procedure, but the procedure was eventually converted to a rectal resection and coloanal anastomosis through the same incision.


RESULTS
One early and one late anastomotic complication occurred. Both were successfully treated with a temporary fecal diversion (left-sided colostomy for 6 to 8 weeks). The functional results as evaluated with anorectal manometry were similar to a group of Hirschsprung's patients treated with transabdominal pull-through resection and coloanal anastomosis.


CONCLUSIONS
This approach might prove to be a useful alternative both to the transabdominal resection and the posterior longitudinal rectal myectomy in Hirschsprung's disease with rectal aganglionosis.
Hedlund
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D002648:Child; D002675:Child, Preschool; D005260:Female; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D012002:Rectal Diseases / Q000601:surgery*; D012810:Sigmoid Diseases / Q000601:surgery