Role of anorectal myectomy in manegment of functional outlet obstruction

ABSTRACT

this work aim to study the value of anorectal myectomy in diagnosis and treatment of functional outlet obstruction, twenty five patients with functional outlet obstruction were subjected to anorectal myectomy and biopsies were taken and examined for ganglionic state. All patients were subjected preoperatively to colonoscopy or barium, flexible sigmoidoscopy, colon transit time, standard proctograhy, anorectal manometry, pre-operative scoring of their constipation. Postoperatively patients were followed up for at least one year, where colon transit time and anorectal manometry were redone, and rescoring of their constipation. There was clinical improvement in 15 patients [60%] of these 10 were males, and histopathological examination of the specimen proved to be aganglionic in 9 patients [60%]. There was no clinical improvement in the other 10 patients of these 7 were males, and biopsy was aganglionic in only 3 patients [30%].anorectal myectomy is a promising diagnostic and therapeutic options in cases of functional outlet obstruction, provided careful patient selection and adequate physiological tests were done to the selected patients