Treatment of Total Colonic Aganglionosis by a Modified Martin Procedure - A Preliminary Report

Abstract

We report on a case of total colonic aganglionosis successfully treated by a modified Martin procedure under the specific environmental circumstances of a developing country. The single-approach procedure comprises a preservation of the ileocaecal valve and a long ileum patch for the remaining colon and rectum after left hemicolectomy with the advantage of restitution of normal stool habits due to enhanced absorption function of the remaining colon.

Long-Term Results of the Treatment of Total Colonic Aganglionosis with Two Different Techniques

“…Duhamel-based pull-through with side-to-side ileocolonic anastomosis proposed by Martin [20] was for years the predominant treatment [5,10,13,18,21,29,30]. Preservation of the absortive function of the aganglionic colon was attempted with several types of colonic patches [1,2,4,9,10,13,16,22,23,29,30] although straight ileo-anal pull-through with either Duhamel, Soave or Swenson techniques can serve the same purpose [7,8,11,32]. The first of the surgical techniques used at our institution to treat this condition deserves particular comment.…”