A recent study published in Khirurgiia evaluated the results of Rehbein procedure with extraperitoneal colorectal anastomosis combined with complex conservative treatment in children with secondary megacolon due to chronic constipation. This study entailed surgical interventions in 78 children aged 7-12 years with chronic colostasis, who were resistant to conservative treatment. These patients were divided into 3 groups, depending on type of surgery: group I – comprised 28 patients with colon resection followed by intraperitoneal colorectal anastomosis; group II – consisted of 29 patients with open Rehbein procedure; and group III – included 21 patients who underwent laparoscopic Rehbein procedure. It was observed that the absence of dyspeptic disorders and enterocolitis in remote postoperative period, in patients receiving comprehensive treatment enhanced with new additions is the cause of improved outcomes. It was suggested that the type of surgery should be individualized in view of anatomical colon changes and secondary pathological conditions. Some pathological symptoms observed at a preoperative stage may recur long-term, post-operatively, due to wrong selection of surgery. Moreover, the risk of recurrent chronic constipation is high after colon resection followed by intraperitoneal colorectal anastomosis. Therefore, it was concluded that Rehbein procedure may be preferred for management of secondary megarectum and megasigma. Further, the laparoscopic technique reduces surgical trauma and requires less postoperative analgesia.¹

Reference

1. Polukhov R. Rehbein procedure for secondary megacolon in children. Khirurgiya Zhurnal im NI Pirogova. 2017;(11):28. doi:10.17116/hirurgia20171128-31.