Rectal myectomy in Hirschsprung disease: a decade of experience

Short-segment aganglionosis is becoming more frequently recognized in view of more sophisticated diagnostic techniques, as well as the greater clinical awareness of the entity. A series of 37 patients who underwent rectal myectomy during a ten-year period was reviewed. Selected patients with short-segment aganglionosis, proved by muscle biopsy, responded well to a single transanal operation that required an overnight hospital stay. The complications were minimal, and the cure or marked improvement has persisted for as long as 11 years. When major surgery of an abdominoperineal pull-through type was required after the myectomy (four patients), no technical difficulties were encountered. Within the limits of its applicability, rectal myectomy has a definite place in the treatment of short-segment Hirschsprung disease.