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Role of Ano Rectal Myomectomy in Children with Chronic Refractory Constipation

BACKGROUND: Chronic refractory constipation (CRC) is an uncommon type of constipation. These children have persistent symptoms even after treatment with high dose laxatives, which may cause abdominal distension, vomiting, cramping and bloating. We conducted this study to assess the diagnostic and th...

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Autores principales: Redkar, Rajeev Gurunath, Raj, Vinod, Bangar, Anant, Hathiramani, Varun, Chigicherla, Swathi, Tewari, Shruti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419556/
https://www.ncbi.nlm.nih.gov/pubmed/30829306
http://dx.doi.org/10.4103/ajps.AJPS_99_17
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author Redkar, Rajeev Gurunath
Raj, Vinod
Bangar, Anant
Hathiramani, Varun
Chigicherla, Swathi
Tewari, Shruti
author_facet Redkar, Rajeev Gurunath
Raj, Vinod
Bangar, Anant
Hathiramani, Varun
Chigicherla, Swathi
Tewari, Shruti
author_sort Redkar, Rajeev Gurunath
collection PubMed
description BACKGROUND: Chronic refractory constipation (CRC) is an uncommon type of constipation. These children have persistent symptoms even after treatment with high dose laxatives, which may cause abdominal distension, vomiting, cramping and bloating. We conducted this study to assess the diagnostic and therapeutic role of anorectal myomectomy in children with CRC. MATERIALS AND METHODS: This study includes 107 patients who fit the criteria of CRC. Complete bowel preparation with polyethylene glycol solution, enemas and antibiotics was carried out before surgery in all patients. The anorectal myomectomy was carried out under general anaesthesia with the patient in the high lithotomy position. The patients were followed up from 6 months to 13 years postoperatively. The success of myomectomy was based on the daily and complete passage of stools without the need for medication or enemas. RESULTS: A total of 99 patients were included in the study, of which, 86 (86.86%) patients showed a good response to anorectal myomectomy. Of these, 32 patients had normal histology, 14 had histology suggestive of Hirschsprung's disease, 8 had hypoganglionosis, 10 had ultra-short segment Hirschsprung's disease and 22 had hypertrophic nerves with immature ganglia. Poor response was seen in 13 (13.13%) patients of whom 5 had normal histology, 5 had Hirschsprung's disease, 2 had hypoganglionosis and 1 had ultra-short segment Hirschsprung's disease. CONCLUSION: Anorectal myomectomy is an effective and technically simple procedure in selected patients with CRC for both diagnostic and therapeutic purposes.
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spelling pubmed-64195562019-04-17 Role of Ano Rectal Myomectomy in Children with Chronic Refractory Constipation Redkar, Rajeev Gurunath Raj, Vinod Bangar, Anant Hathiramani, Varun Chigicherla, Swathi Tewari, Shruti Afr J Paediatr Surg Original Article BACKGROUND: Chronic refractory constipation (CRC) is an uncommon type of constipation. These children have persistent symptoms even after treatment with high dose laxatives, which may cause abdominal distension, vomiting, cramping and bloating. We conducted this study to assess the diagnostic and therapeutic role of anorectal myomectomy in children with CRC. MATERIALS AND METHODS: This study includes 107 patients who fit the criteria of CRC. Complete bowel preparation with polyethylene glycol solution, enemas and antibiotics was carried out before surgery in all patients. The anorectal myomectomy was carried out under general anaesthesia with the patient in the high lithotomy position. The patients were followed up from 6 months to 13 years postoperatively. The success of myomectomy was based on the daily and complete passage of stools without the need for medication or enemas. RESULTS: A total of 99 patients were included in the study, of which, 86 (86.86%) patients showed a good response to anorectal myomectomy. Of these, 32 patients had normal histology, 14 had histology suggestive of Hirschsprung's disease, 8 had hypoganglionosis, 10 had ultra-short segment Hirschsprung's disease and 22 had hypertrophic nerves with immature ganglia. Poor response was seen in 13 (13.13%) patients of whom 5 had normal histology, 5 had Hirschsprung's disease, 2 had hypoganglionosis and 1 had ultra-short segment Hirschsprung's disease. CONCLUSION: Anorectal myomectomy is an effective and technically simple procedure in selected patients with CRC for both diagnostic and therapeutic purposes. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6419556/ /pubmed/30829306 http://dx.doi.org/10.4103/ajps.AJPS_99_17 Text en Copyright: © 2019 African Journal of Paediatric Surgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Redkar, Rajeev Gurunath
Raj, Vinod
Bangar, Anant
Hathiramani, Varun
Chigicherla, Swathi
Tewari, Shruti
Role of Ano Rectal Myomectomy in Children with Chronic Refractory Constipation
title Role of Ano Rectal Myomectomy in Children with Chronic Refractory Constipation
title_full Role of Ano Rectal Myomectomy in Children with Chronic Refractory Constipation
title_fullStr Role of Ano Rectal Myomectomy in Children with Chronic Refractory Constipation
title_full_unstemmed Role of Ano Rectal Myomectomy in Children with Chronic Refractory Constipation
title_short Role of Ano Rectal Myomectomy in Children with Chronic Refractory Constipation
title_sort role of ano rectal myomectomy in children with chronic refractory constipation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419556/
https://www.ncbi.nlm.nih.gov/pubmed/30829306
http://dx.doi.org/10.4103/ajps.AJPS_99_17
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