title: [Application of partial internal sphincter myomectomy in patients with Hirschsprung disease undergoing transanal one-stage pull-through operation].
abstract: OBJECTIVE
  To investigate the effect of partial internal sphincter myomectomy on transanal one-stage pull-through operation for Hirschsprung disease (HD).
  
  
  METHODS
  A prospective group of 153 pediatric patients with HD in Guangdong Dongguan People's Hospital between 2003-2012 were enrolled, who underwent transanal one-stage pull-through operation. Children were divided into partial resection group (77 cases) undergoing partial internal sphincter myomectomy and simple incision group (76 cases) undergoing simply internal sphincter dissection, respectively. Differences of postoperative complications and continence between two groups were compared.
  
  
  RESULTS
  Postoperative complications such as rectal muscularis infection [1.3% (1/77) vs. 11.8% (9/76), P<0.05], enterocolitis [2.6% (2/77) vs. 13.2% (10/76), P<0.05], anastomosis stenosis[3.9% (3/77) vs. 22.4% (17/76), P<0.01] and abdominal distension [10.4% (8/77) vs. 25.0% (19/76), P<0.05] were lower in partial resection group as compared to simple incision group. The time of antibiotics administration was also lower in partial resection group [(3.9±1.1) d vs. (4.6±1.1) d, P<0.01]. Difference in the continence between the two groups was not statistically significant (kelly score, 5.1±0.5 vs. 5.2±0.6, P>0.05).
  
  
  CONCLUSIONS
  Compared with simply internal sphincter dissection in operation, partial internal sphincter myomectomy with transanal one-stage pull-through operation for HD can reduce the postoperative complications and does not increase the damage of the continence.
authors.affiliation: Department of General Surgery, Dongguan People's Hospital, Guangdong Dongguan, China. 18925800766@189.cn
authors.forename: Li-yong
authors.initials: LY
authors.lastname: Wang
authors.forename: Rui-ping
authors.initials: RP
authors.lastname: Li
authors.forename: Hao-tang
authors.initials: HT
authors.lastname: Ren
authors.forename: Yi-jun
authors.initials: YJ
authors.lastname: Wang
authors.forename: Shu-ming
authors.initials: SM
authors.lastname: Yuan
authors.forename: Xian-zhi
authors.initials: XZ
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D001003:Anal Canal / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006627:Hirschsprung Disease / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome