Rehbein procedure for secondary megacolon in children.


eMediNexus    04 April 2018

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 resistant to conservative treatment. These patients were divided into three groups depending on the type of surgery conducted; vis, group I – colon resection followed by intraperitoneal colorectal anastomosis (28 patients); group II – open Rehbein procedure (29 patients); and group III – laparoscopic Rehbein procedure (21 patients). The findings revealed that the absence of dyspeptic disorders and enterocolitis in remote postoperative period in patients receiving comprehensive treatment improved with new additions is the cause of improved outcomes. Meanwhile, it was realized that the type of surgery should be individualized in view of anatomical colon changes and secondary pathological conditions. It was also noted that some pathological symptoms observed at preoperative period may be recurrent in long-term postoperative period due to wrong selection of surgery. Furthermore, the risk of recurrent chronic constipation was high after colon resection followed by intraperitoneal colorectal anastomosis. Hence, it was concluded that Rehbein procedure may be preferred for management of secondary megarectum and megasigma. While, laparoscopic technique reduces surgical trauma and requires less postoperative analgesia.

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