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Surgical treatment of idiopathic megarectum in constipated children

Igor V Kirgizov1, Sergey V Minaev2, Ilya Shishkin1

  • 1Department of Pediatric Surgery, National Medical Research Center of Children's Health, Lomonosov Avenue, 2, building 1, Moscow, Russian Federation.

Journal of Pediatric Surgery
|December 23, 2018
PubMed

Insights

Laparoscopic low anterior resection is superior to the Soave procedure for treating pediatric idiopathic megarectum, significantly reducing complications like anastomosis leakage and frequent loose stools with soiling. This surgical approach offers better functional outcomes for children with chronic constipation.

Area of Science:

  • Pediatric surgery
  • Gastroenterology
  • Colorectal surgery

Background:

  • Chronic constipation in children is often linked to primary megarectum.
  • Idiopathic megarectum requires effective surgical interventions.

Purpose of the Study:

  • To compare surgical outcomes for idiopathic megarectum in children.
  • To evaluate the efficacy of Soave pull-through versus laparoscopic low anterior resection.

Main Methods:

  • Retrospective comparative study of 52 children with idiopathic megarectum.
  • Two groups: Soave pull-through (n=23) and laparoscopic low anterior resection with stapled anastomosis (n=29).
  • Evaluations included clinical assessment, manometry, colonoscopy, and contrast enema.

Main Results:

  • Anastomosis leakage occurred in 26.1% of Soave patients vs. 3.5% of laparoscopic patients (P=0.049).
  • Frequent loose stools with soiling were significantly higher in the Soave group (60.9%) compared to the laparoscopic group (13.8%) (P=0.001).
  • No significant difference in long-term constipation rates between groups.

Conclusions:

  • Laparoscopic low anterior resection with ultrasound guidance is a preferred surgical option for pediatric idiopathic megarectum.
  • This approach yields good functional results and fewer complications compared to the Soave procedure.
  • The study highlights the benefits of minimally invasive techniques in pediatric colorectal surgery.
Abstract

Keywords:
ChildrenConstipationIdiopathic megarectumLaparoscopyOutcomeSurgeryTreatment

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