[ outcome of transanal anorectal myectomy in the patients with ultrashort_segment hirschsprung's disease]

ABSTRACT

Anorectal myectomy and anal dilation under anesthesia could be an effective way in the treatment of patients with ultrashort_segment Hirschprung.In this article we studied the outcomes of anorectal myectomy. Our study group was 61 patients with the disease who had reffered to SHEIKH hospital from the second half of 1386 to the first half of 1388. Barium enema and anorectal myectomy was performed in all patient. Follow up after myectomy was in the second week after surgery and then monthly. For the complications and results, patients were also divided in to 3 groups based on the presence or absence of ganglion cell in the muscular resectal region,and the results were compared in each group. Bleeding, infection of the operation zone, sepsis, entrocolitis, and anal stenosis was not observed in any patient after surgery. 4 patients had gas incontinence and 3 had fecal incontinence after surgery which was cured in 3-6 months with bio-feedback orders. 40 patients [87.5%] had complete remission after surgery and 2[4.17%] had partial remission and 4[8.33%] had no remission at all. Based on these results, there is no relation between gender, complications of surgery and the results of surgery. Anorectal myectomy could be an effective treatment strategy for patients with following situations absence of anatomical abnormalities-chronic constipation in spite of medical treatment-absence of transitional zone in barium enema-failure of anorectal reflex relaxation with rectal distention in anorectal manometry