Role of anorectal myectomy after failed endorectal pull-through in Hirschsprung's disease

Banani, Seyed Abbas; Forootan, Hamid Reza

doi:10.1016/0022-3468(94)90102-3

Cited by 59 publications

(16 citation statements)

References 14 publications

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“…Anal achalasia can also occur in otherwise healthy children [4] and has been identified in up to 4.5% of children with chronic constipation [1]. The condition has been traditionally treated with IAS myotomy or myectomy [1,[5][6][7]. However, by permanently weakening the sphincter, these procedures can lead to fecal incontinence.…”

Section: Introductionmentioning

confidence: 99%

Botulinum toxin for the treatment of chronic constipation in children with internal anal sphincter dysfunction

et al. 2008

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Internal anal sphincter (IAS) dysfunction is a cause of refractory constipation in children. The goal of this study was to determine whether intrasphincteric injection of botulinum toxin is effective in the treatment of constipation in pediatric patients with IAS dysfunction. A retrospective review was performed of 24 pediatric patients with intractable constipation. All patients had abnormal anorectal manometry, with either elevated IAS resting pressure (> or =100 mm Hg) or an absent or diminished rectoanal inhibitory reflex. Patients with Hirschsprung's disease were excluded. All patients underwent botox injection into the IAS and were followed for a minimum of 6 months. Of 24 patients, 22 experienced significant improvement in their constipation lasting greater than 2 weeks. The duration of effect was variable, with 12 patients demonstrating benefit lasting at least 6 months. Transient postoperative incontinence occurred in five patients. Intrasphincteric injection of botox is a safe and effective treatment for intractable constipation in children with IAS dysfunction.

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Section: Introductionmentioning

confidence: 99%

Botulinum toxin for the treatment of chronic constipation in children with internal anal sphincter dysfunction

et al. 2008

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“…[1][2][3] In some children, obstructive symptoms are thought to be caused by hypertonicity of the internal anal sphincter associated with absence of the rectoanal reflex, a condition that has been termed internal sphincter achalasia. Many surgeons advocate internal sphincter myectomy or sphincterotomy [4][5][6] for this problem. Despite their popularity, however, these procedures are not universally effective and may result in permanent injury to the sphincter.…”

mentioning

confidence: 99%

A prospective study of botulinum toxin for internal anal sphincter hypertonicity in children with Hirschsprung's disease

Minkes

Langer

2000

Journal of Pediatric Surgery

110

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Background:Internal anal sphincter hypertonicity with nonrelaxation can cause persistent constipation and obstructive symptoms in children after surgery for Hirschsprung's disease. Intractable symptoms traditionally have been treated with anal myectomy, which may be ineffective or complicated by long-term incontinence. The authors evaluated prospectively the use of intrasphincteric botulinum toxin for these patients.

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“…9 The conventional treatment of IAS dysfunction has involved either forceful anal dilatation or surgical disruption of the IAS via myotomy or myectomy which had reportedly with normalization of the IAS and improvement in constipation. [10][11][12][13] However, while division of the sphincter is an effective method, it risks permanent weakening of the IAS with potential long-term consequences.…”

Section: Discussionmentioning

confidence: 99%

The use of botulinum toxin in children with chronic constipation

et al. 2017

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Background: Conventional therapy of childhood constipation was based on dietary manipulation, stool softeners and oral laxatives. Although these forms of medications are successful in the majority of cases, still small subgroup of patients may fail to respond to this treatment. The aim of this study was to evaluate the role of botulinum toxin in relieving the symptoms of those patients.Methods: This study was conducted on 20 cases with chronic constipation that fail to respond to conventional medical treatment. Cases under went any previous surgical maneuver will be excluded from study. Anal dilatation was started by Higar dilators then small self-retaining anal retractors were introduced and four injections were made into the four quadrants of the anal canal and rectum at the level of IAS (internal anal sphincter).Results: twenty cases were included (14 males and 6 females) with age ranged from 8 months to 6 years. The botulinum injection per patients ranged from 1 to 2 injections. The response rate to this treatment was excellent in 6 cases and good in 12 cases and poor in 2 cases. No systemic or local complications occurred in any patients.Conclusions: botulinum toxin injection could be safe and effective treatment of chronic constipation in infants and children.

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Role of anorectal myectomy after failed endorectal pull-through in Hirschsprung's disease

Cited by 59 publications

References 14 publications

Botulinum toxin for the treatment of chronic constipation in children with internal anal sphincter dysfunction

Botulinum toxin for the treatment of chronic constipation in children with internal anal sphincter dysfunction

A prospective study of botulinum toxin for internal anal sphincter hypertonicity in children with Hirschsprung's disease

The use of botulinum toxin in children with chronic constipation

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