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Sherif M. K. Shehata, MB, BCh, MS; Ibrahim A. El-Banna, MD; Ahmed A. Gaber, MD; Ahmed M. El-Samongy, MD; Mohamed A. Attia, MD

Arch Surg. 1998;133:269-271.

Objectives  To provide a simple myomectomy technique for low-segment Hirschsprung disease and evaluate the efficacy of the new modification.

Design  Case series of 19 patients followed up for 12 to 56 months (mean, 39.1 months).

Setting  Tanta University Hospital, Tanta, Egypt.

Participants  Nineteen patients aged 4 months to 10 years complaining of chronic constipation, with radiological and clinical data suggestive of low-segment Hirschsprung disease proven by histological examination.

Intervention  Modified lateral anorectal myomectomy.

Main Outcome Measures  Clinical and radiological improvement measured by postoperative barium enema, bowel habits, and patient's relief of symptoms.

Results  Seventeen of 19 patients improved clinically and 13 showed radiological improvement 3 years postoperatively. There was poor response in 2 patients, who were subjected to further Soave procedures.

Conclusion  Modified lateral anorectal myomectomy is an effective and technically simple procedure in patients suspected of having low-segment Hirschsprung disease.

From the Section of Pediatric Surgery, Surgery Department, Tanta University Hospital, Tanta, Egypt (Drs El-Banna, Gaber, El-Samongy, and Attia); and the Department of Pediatric Surgery, Sophia Children's Hospital, Rotterdam, the Netherlands (Dr Shehata).