[Ano-rectal sphincter myectomy in children. Indications and results]

Ano-rectal myectomy, described by B. Duhamel in 1965, is the logical therapy of rectoanal achalasia; an experience of 117 cases is reported. Clinical examination and radiological investigations have been made prior to surgery. This surgical procedure is simple, without complication. Three kinds of rectoanal achalasia are described: achalasia with structural change of the internal sphincter (fibrosis, sclerosis); achalasia with a functional sphincteric disorder (with normal histology); achalasia with intrinsic innervation abnormality. Excellent results have been observed in the two first groups but more variable successful results in the third group which concerns short segments of Hirschsprung's disease.