Results of Posterior Myectomy for the Treatment of Children with Chronic Constipation.


eMediNexus    08 May 2018

The purpose of a study published in Arquivos de Gastroenterologia was to evaluate the result of posterior myectomy in children with chronic constipation. This study recruited 48 children, 21 males and 27 females in the age-range of 1.5-11 years, with chronic constipation who did not respond to diet, laxative or enema. All patients underwent posterior myectomy and were followed for one year after surgery, for frequency of fecal evacuation, fecal consistency, straining during defecation, and diameter of the feces. The findings revealed that the mean duration of constipation before surgery was 22.79±17.08 (range 6-48 months). Mean duration of medical treatment was 14.90±10.31 (range= 6-48 months). When fecal consistency, feces diameter, number of bowel movements and straining during defecation were compared before and after surgery, the results were found to be statistically significant. Among all cases, 52% continued treatment of constipation after surgery for a year. Ganglion cells were absent in 32 cases, but present in seven children. Meanwhile, proximal ganglion cell was found in nine cases. On the other hand, the treatment response was not different between cases according to the status of ganglion cell on biopsy. Thus, it was concluded that fecal consistency, feces diameter, number of bowel movements, and straining for defecation were improved after posterior myectomy.

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