| Long-term outcome of internal sphincter myectomy in patients with internal anal sphincter achalasia. | |
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MedLine Citation:
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PMID: 19680665 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Internal anal sphincter achalasia (IASA) is a condition with presentation similar to Hirschsprung's disease (HD), but with the presence of ganglion cells on rectal suction biopsy (RSB). The diagnosis is made on anorectal manometry (ARM) by the absence of the rectosphincteric reflex on rectal balloon inflation. Internal sphincter myectomy (ISM) is the treatment of choice for patients with IASA. Recently, botulinum toxin has been used to treat IASA patients. The purpose of this study was to assess the long-term bowel function in patients with IASA following ISM. METHODS: The medical records of 24 patients with IASA managed by ISM during 1993-2005 were examined. There were 18 boys and 6 girls, aged 2-12 years. All patients presented with intractable constipation with or without soiling. The diagnosis was made by the demonstration of the absence of the rectosphincteric reflex on ARM. HD was excluded by the presence of ganglion cells and normal acetylcholinesterase activity in RSB. Patients were followed 4-14 years later. RESULTS: Fifteen (62.5%) patients at the time of follow-up had regular bowel motions without the use of laxatives. Six (25%) patients had regular bowel motions, but remained on small doses of laxatives. Two (8.3%) patients who suffered from constipation and soiling required twice weekly enemas to remain clean. One (4.2%) patient required resection of dilated rectosigmoid colon 3 years after myectomy, remains on laxatives, but has normal bowel control. No patients had faecal incontinence following ISM. CONCLUSION: This long-term follow-up study shows that the vast majority of IASA patients have normal bowel control following ISM. |
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Authors:
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Reshma Doodnath; Prem Puri |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pediatric surgery international Volume: 25 ISSN: 1437-9813 ISO Abbreviation: Pediatr. Surg. Int. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-25 Completed Date: 2009-12-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8609169 Medline TA: Pediatr Surg Int Country: Germany |
Other Details:
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Languages: eng Pagination: 869-71 Citation Subset: IM |
Affiliation:
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Children's Research Centre, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anal Canal
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abnormalities*,
surgery* Child Child, Preschool Constipation / etiology Digestive System Abnormalities / complications, surgery* Digestive System Surgical Procedures / methods* Female Follow-Up Studies Humans Male Recovery of Function Retrospective Studies Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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