Surgical treatment of idiopathic megarectum in constipated children

Kirgizov, Sergey; Minaev, Sergey; Шишкин, И А; Aprosimova, Svetlana; Ukhina, Luiza

doi:10.1016/j.jpedsurg.2018.10.103

Cited by 8 publications

(9 citation statements)

References 22 publications

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“…Another theory suggests that the development of the idiopathic megacolon is based on degenerative changes in smooth muscle tissue [20,25]. The alteration of colonic muscle cells in the case of idiopathic megacolon in cats [26,27], and similar changes identified in mice [28], are also documented.…”

Section: Smooth Muscle Cellsmentioning

confidence: 99%

“…Changes in Cajal interstitial cell numbers are described in patients with idiopathic megacolon or chronic constipation by numerous studies and suggested as an etiopathogenic basis [18][19][20][21][22][23][24]. They are considered a true intestinal pacemaker ("little brain" at the enteral level); however, starting from the premise that their number decreases physiologically with age anyway and by the fact that a number of other communications do not confirm their involvement in the etiopathogenesis of idiopathic megacolon, this theory remains for the moment only a new subject of controversy [8].…”

Section: Cajal Cellsmentioning

confidence: 99%

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Idiopathic Megacolon—Short Review

et al. 2021

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Introduction: Idiopathic megacolon (IM) is a rare condition with a more or less known etiology, which involves management challenges, especially therapeutic, and both gastroenterology and surgery services. With insufficiently drawn out protocols, but with occasionally formidable complications, the condition management can be difficult for any general surgery team, either as a failure of drug therapy (in the context of a known case, initially managed by a gastroenterologist) or as a surgical emergency (in which the diagnostic surprise leads additional difficulties to the tactical decision), when the speed imposed by the severity of the case can lead to inadequate strategies, with possibly critical consequences. Method: With such a motivation, and having available experience limited by the small number of cases (described by all medical teams concerned with this pathology), the revision of the literature with the update of management landmarks from the surgical perspective of the pathology appears as justified by this article. Results: If the diagnosis of megacolon is made relatively easily by imaging the colorectal dilation (which is associated with initial and/or consecutive clinical aspects), the establishing of the diagnosis of idiopathic megacolon is based in practice almost exclusively on a principle of exclusion, and after evaluating the absence of some known causes that can lead to the occurrence of these anatomic and clinical changes, mimetically, clinically, and paraclinically, with IM (intramural aganglionosis, distal obstructions, intoxications, etc.). If the etiopathogenic theories, based on an increase in the performance of the arsenal of investigations of the disease, have registered a continuous improvement and an increase of objectivity, unfortunately, the curative surgical treatment options still revolve around the same resection techniques. Moreover, the possibility of developing a form of etiopathogenic treatment seems as remote as ever.

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Section: Smooth Muscle Cellsmentioning

confidence: 99%

Section: Cajal Cellsmentioning

confidence: 99%

Idiopathic Megacolon—Short Review

et al. 2021

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“…Surgery С воевременная диагностика и хирургическое лечение заболеваний органов брюшной полости у недоношенных детей, угрожаемых по перфорации кишечника, имеют особую актуальность из-за увеличения числа таких пациентов в палатах реанимации и интенсивной терапии [1][2][3]. Перфорации кишечника в этой когорте детей происходит как спонтанно, так и вследствие острых процессов в брюшной полости, характерных только для этой возрастной группы [4].…”

Section: хирургия Original Researchunclassified

The choice of the method of enterostomy in the treatment of congenital malformations and diseases of the gastrointestinal tract in premature infants

Prisukha¹,

Aksel’rov²,

Babich³

et al. 2021

Medical news of the North Caucasus

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The choice of The meThoD of enTerosTomY in The TreaTmenT of congeniTal malformaTions anD Diseases of The gasTroinTesTinal TracT in premaTure infanTs prisukha i. n. 1 , akselrov m. a. 3 , Babich i. i. 4 , Belotserkovtseva l. D. 1, 2 , minaev s. V. 5 , lukash Yu. V. 4 , melnikov Yu. n. 4 1 surgut District clinical center for maternity and childhood protection, russian federation 2 surgut state university (medical institute), russian federation 3 Tyumen state medical university, russian federation 4 rostov state medical university, rostov-on-Don, russian federation 5 stavropol state medical university, russian federation Произведен ретроспективный анализ результатов хирургического лечения 131 недоношенного ребенка с врожденными пороками развития и заболеваниями желудочно-кишечного тракта, потребовавших наложения различных видов энтеростом с 2008 по 2019 г. Исследование показало, что проведение одноствольной энтеростомии, в отличие от двойной концевой энтеростомии, сопровождается значительно меньшим количеством осложнений (парастомического дерматита, эвагинации, пролапса и остеопении), а также обеспечивает более комфортные условия в уходе за стомой в послеоперационном периоде у недоношенных детей.

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“…36 There are still many reports describing major procedures to treat FC with "failure of medical management" in patients for whom an ACE was not tried first. 34,35,[37][38][39] On the other hand, others propose always using an ACE procedure as a first step and these authors only perform more aggressive interventions in those with failure of management with ACE. 33 It is likely that with more uniform motility testing and use of antegrade flushes only, fewer colonic resections will be needed.…”

Section: Colonic Resectionmentioning

confidence: 99%

Surgical Interventions for Functional Constipation: An Update

Vilanova-Sánchez

Levitt

2020

Eur J Pediatr Surg

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Chronic idiopathic constipation, also known as functional constipation, is defined as difficult and infrequent defecation without an identifiable organic cause. Medical management with laxatives is effective for the majority of constipated children. However there is a subset of patients who may need evaluation by a surgeon. As constipation progresses, it can lead to fecal retention and rectal and sigmoid distension, which impairs normal colorectal motility. Surgical interventions are influenced by the results of: a rectal biopsy, transit studies, the presence of megacolon/megarectum on contrast enema, the degree of soiling/incontinence, anorectal manometry findings, and colonic motility evaluation. In this review, we describe the different surgical options available (intestinal diversion, antegrade enemas, sacral nerve stimulation, colonic resections, and Botulinum toxin injection) and provide guidance on how to choose the best procedure for a given patient.

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Surgical treatment of idiopathic megarectum in constipated children

Cited by 8 publications

References 22 publications

Idiopathic Megacolon—Short Review

Idiopathic Megacolon—Short Review

The choice of the method of enterostomy in the treatment of congenital malformations and diseases of the gastrointestinal tract in premature infants

Surgical Interventions for Functional Constipation: An Update

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