Role of anorectal myectomy after failed endorectal pull-through in Hirschsprung's disease
Thirty-seven patients with Hirschsprung's disease (HD) underwent endorectal pull-through (ERPT). Six children had signs and symptoms similar to those of their preoperative state, and their conditions did not respond to conservative therapy. Anorectal manometry showed high anal canal pressure in...
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Veröffentlicht in: | Journal of pediatric surgery 1994-10, Vol.29 (10), p.1307-1309 |
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creator | Banani, S.Abbas Forootan, Hamid |
description | Thirty-seven patients with Hirschsprung's disease (HD) underwent endorectal pull-through (ERPT). Six children had signs and symptoms similar to those of their preoperative state, and their conditions did not respond to conservative therapy. Anorectal manometry showed high anal canal pressure in these patients. Anorectal myectomy (ARM), which included posterior rectal myectomy with partial internal sphincterotomy, was performed 6 to 55 months after ERPT. Five patients had marked improvement, and one had a partial response. Anal canal pressure was reduced significantly in all six patients. ARM is recommended after ERPT if constipation, abdominal distension, or repeated enterocolitis, unresponsive to conservative therapy, occurs. ARM should be performed before the patient is considered a candidate for a secondary pull-through operation. |
doi_str_mv | 10.1016/0022-3468(94)90102-3 |
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Six children had signs and symptoms similar to those of their preoperative state, and their conditions did not respond to conservative therapy. Anorectal manometry showed high anal canal pressure in these patients. Anorectal myectomy (ARM), which included posterior rectal myectomy with partial internal sphincterotomy, was performed 6 to 55 months after ERPT. Five patients had marked improvement, and one had a partial response. Anal canal pressure was reduced significantly in all six patients. ARM is recommended after ERPT if constipation, abdominal distension, or repeated enterocolitis, unresponsive to conservative therapy, occurs. ARM should be performed before the patient is considered a candidate for a secondary pull-through operation.</description><identifier>ISSN: 0022-3468</identifier><identifier>EISSN: 1531-5037</identifier><identifier>DOI: 10.1016/0022-3468(94)90102-3</identifier><identifier>PMID: 7807312</identifier><identifier>CODEN: JPDSA3</identifier><language>eng</language><publisher>Philadelphia, PA: Elsevier Inc</publisher><subject>Adolescent ; Anal Canal - surgery ; Anastomosis, Surgical ; Biological and medical sciences ; Child ; Child, Preschool ; Constipation - etiology ; Constipation - surgery ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Hirschsprung Disease - surgery ; Humans ; Infant ; Male ; Medical sciences ; Other diseases. Semiology ; Postoperative Complications - surgery ; Rectum - surgery ; Reoperation ; Stomach. Duodenum. Small intestine. Colon. Rectum. 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Six children had signs and symptoms similar to those of their preoperative state, and their conditions did not respond to conservative therapy. Anorectal manometry showed high anal canal pressure in these patients. Anorectal myectomy (ARM), which included posterior rectal myectomy with partial internal sphincterotomy, was performed 6 to 55 months after ERPT. Five patients had marked improvement, and one had a partial response. Anal canal pressure was reduced significantly in all six patients. ARM is recommended after ERPT if constipation, abdominal distension, or repeated enterocolitis, unresponsive to conservative therapy, occurs. ARM should be performed before the patient is considered a candidate for a secondary pull-through operation.</description><subject>Adolescent</subject><subject>Anal Canal - surgery</subject><subject>Anastomosis, Surgical</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Constipation - etiology</subject><subject>Constipation - surgery</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Hirschsprung Disease - surgery</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Other diseases. Semiology</subject><subject>Postoperative Complications - surgery</subject><subject>Rectum - surgery</subject><subject>Reoperation</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Treatment Failure</subject><issn>0022-3468</issn><issn>1531-5037</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFq3DAQhkVJSTdp36AFHULSHpyOLFuyL4EQ2iYQCIT2kJOQpVFWRba2kl3Yt4-d3e6xp2FmvvkZPkI-MrhkwMRXgLIseCWaz231pQUGc_eGrFjNWVEDl0dkdUDekZOcfwPMY2DH5Fg2IDkrV-TpMQak0VE9xIRm1IH227nGfku1GzFRp31AS3Gw_4DNFEIxrlOcntfUD_TWp2zWeZOm4fkiU-sz6ozvyVunQ8YP-3pKfn3_9vPmtrh_-HF3c31fGN6IsRBaCmwtGFE2UspKokWJNcOOmY5XrgRrjYNSNkaKRotWCJCdqSveGafbkp-S813uJsU_E-ZR9T4bDEEPGKespGgZn_XMYLUDTYo5J3Rqk3yv01YxUItRtehSiy7VVurVqOLz2ad9_tT1aA9He4Xz_my_19no4JIejM8HjHOoW77EXO0wnF389ZhUNh4Hg9YvWpWN_v9_vAChCJJV</recordid><startdate>19941001</startdate><enddate>19941001</enddate><creator>Banani, S.Abbas</creator><creator>Forootan, Hamid</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19941001</creationdate><title>Role of anorectal myectomy after failed endorectal pull-through in Hirschsprung's disease</title><author>Banani, S.Abbas ; Forootan, Hamid</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-6a76e9d0c62877747ede7e51eb1cb34f20ddcf0278c768a696607bc543bcfa923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Adolescent</topic><topic>Anal Canal - surgery</topic><topic>Anastomosis, Surgical</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Constipation - etiology</topic><topic>Constipation - surgery</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Hirschsprung Disease - surgery</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Other diseases. Semiology</topic><topic>Postoperative Complications - surgery</topic><topic>Rectum - surgery</topic><topic>Reoperation</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Banani, S.Abbas</creatorcontrib><creatorcontrib>Forootan, Hamid</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Banani, S.Abbas</au><au>Forootan, Hamid</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of anorectal myectomy after failed endorectal pull-through in Hirschsprung's disease</atitle><jtitle>Journal of pediatric surgery</jtitle><addtitle>J Pediatr Surg</addtitle><date>1994-10-01</date><risdate>1994</risdate><volume>29</volume><issue>10</issue><spage>1307</spage><epage>1309</epage><pages>1307-1309</pages><issn>0022-3468</issn><eissn>1531-5037</eissn><coden>JPDSA3</coden><abstract>Thirty-seven patients with Hirschsprung's disease (HD) underwent endorectal pull-through (ERPT). Six children had signs and symptoms similar to those of their preoperative state, and their conditions did not respond to conservative therapy. Anorectal manometry showed high anal canal pressure in these patients. Anorectal myectomy (ARM), which included posterior rectal myectomy with partial internal sphincterotomy, was performed 6 to 55 months after ERPT. Five patients had marked improvement, and one had a partial response. Anal canal pressure was reduced significantly in all six patients. ARM is recommended after ERPT if constipation, abdominal distension, or repeated enterocolitis, unresponsive to conservative therapy, occurs. ARM should be performed before the patient is considered a candidate for a secondary pull-through operation.</abstract><cop>Philadelphia, PA</cop><pub>Elsevier Inc</pub><pmid>7807312</pmid><doi>10.1016/0022-3468(94)90102-3</doi><tpages>3</tpages></addata></record> |
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subjects | Adolescent Anal Canal - surgery Anastomosis, Surgical Biological and medical sciences Child Child, Preschool Constipation - etiology Constipation - surgery Female Gastroenterology. Liver. Pancreas. Abdomen Hirschsprung Disease - surgery Humans Infant Male Medical sciences Other diseases. Semiology Postoperative Complications - surgery Rectum - surgery Reoperation Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Treatment Failure |
title | Role of anorectal myectomy after failed endorectal pull-through in Hirschsprung's disease |
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