Abstract
Purpose: Surgical treatment of anorectal anomalies may be followed by severe constipation with or without overflow incontinence secondary to dilation and ectasia of the rectosigmoid. The aim of this study is to evaluate the efficacy of anterior resection and endorectal pull-through for the treatment of rectosigmoid ectasia secondary to posterior sagittal anorectoplasty (PSARP). Material and Method: Seven patients with a history of PSARP presented with serious rectosigmoid ectasia and overflow incontinence of fecal impaction. Four were boys and 3 were girls aged from 16 months to 15 years. Preoperative diagnosis was based on physical examination, barium enema, MRI and rectal biopsy. Surgical treatment of the post-PSARP rectal ectasia was made by anterior resection of the ectatic segment of the sigmoid combined with pull-through of normal colon into the mucosectomized ectatic rectum. Results: During a four-to ten-year follow-up period all of our patients had normal bowel movements. Postoperative barium enema radiography demonstrated a normal rectal caliber and manometry revealed normal anorectal motor function. Conclusions: The good postoperative results draw attention to the following, a) The aim of the surgical treatment of megarectum is to establish a neorectum with normal bowel, b) Resection of megasigmoid and pull-through of bowel with normal caliber into the mucosectomized ectatic rectum is an effective procedure in patients with post-PSARP rectosigmoid ectasia. c) The neorectum attains its reservoir function through a gradual process after resection and endorectal pull-through. © Georg Thieme Verlag KG Stuttgart.
Original language | English |
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Pages (from-to) | 268-272 |
Number of pages | 4 |
Journal | European Journal of Pediatric Surgery |
Volume | 15 |
Issue number | 4 |
DOIs | |
Publication status | Published - Aug 2005 |
Keywords
- Endorectal pull-through
- Rectosigmoid ectasia
- Sigmoid resection