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[Surgical therapy of chronic constipation in pediatric age]
A Ponticelli1, B D Iacobelli, G Mosiello
1Divisione di Chirurgia Pediatrica, Ospedale Bambino Gesù, Roma.
Insights
Sphincteromyectomy effectively treats chronic constipation in children when medical options fail. This surgical approach offers significant symptom improvement and regular bowel movements in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
Context:
- Chronic constipation affects a significant number of children.
- Previous medical treatments were unsuccessful in the studied cohort.
- High anal sphincter tone was a common characteristic in these patients.
Purpose:
- To evaluate the efficacy of posterior sphincteromyectomy for chronic constipation in pediatric patients.
- To assess the role of anorectal manometry in managing this condition.
Summary:
- A study of 19 children with chronic constipation and high anal sphincter tone, unresponsive to medical treatment, underwent posterior sphincteromyectomy.
- Anorectal manometry, defecography, and intestinal transit tests were utilized.
- 17 out of 19 patients experienced notable symptom improvement and normalized bowel function post-surgery.
Impact:
- Sphincteromyectomy is a simple, safe, and effective surgical option for pediatric chronic constipation.
- Anorectal manometry is crucial for guiding the surgical procedure and managing potential complications.
- This intervention can significantly improve the quality of life for children suffering from refractory constipation.
Abstract:
The authors report their experience in the treatment of the chronic constipation in paediatric age. During the last 3 years (1991-1994), 230 children presenting chronic constipation have been studied at the Strumental Gastroenterologic Department of Children Hospital Bambino Gesù; 19 of them (8%), 10 male and 9 female, were studied with anorectal manometry, defecography and Intestinal Transit test. All the patients had a overtone (high squeeze) of the anal sphincter and the medical treatment was unsuccessful. They underwent sphincteromyectomy by posterior approach. In 17 patients it has been obtained a notable improvement of the symptomatology with regularization of the evacuations. The simplicity of the surgical technique, the absence of complications and the obtained results confirm the validity of sphinteromyectomy in the therapy of the chronic constipation in paediatric age. Interoperating anorectal manometry proved to be essential both in modulating sphincteromyectomy and in its eventual complications.