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Long-term results of anorectal myectomy for chronic constipation

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

Anorectal myectomy has been shown to provide clinical benefit to patients with outlet obstruction. Long-term results of anorectal myectomy have been evaluated in 57 patients operated on between February 1984 and February 1988 with a median follow-up of 24 months. Overall improvement was recorded in only 31 percent of patients. Spontaneous evacuation without the need for laxatives was recorded in only 11 patients (19 percent), while 38 (67 percent) had no functional improvement. Results were independent of preoperative colonic transit or histologic evidence of aganglionosis. Anorectal myectomy identified aganglionosis in 23 percent of patients with chronic constipation, but there was minimal long-term benefit from the procedure.

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References

  1. Martelli H, Devroede G, Arhan P, Duguay C. Mechanisms of idiopathic constipation: outlet obstruction. Gastroenterology1978;75:623–30.

    PubMed  Google Scholar 

  2. Yoshioka K, Keighley MR. Anorectal myectomy for outlet obstruction. Br J Surg 1987;74:373–6.

    PubMed  Google Scholar 

  3. Allan A, Keighley MR. Operative approaches to the distal rectum. In: DeCosse J, Todd I, eds. Anorectal surgery: clinical surgery international. New York: Churchill Livingstone, 1987:234–51.

    Google Scholar 

  4. Thomas CG Jr, Bream CA, DeConnick P. Posterior sphincterotomy and rectal myotomy in the management of Hirschsprung's disease. Ann Surg 1970;171:796–809.

    PubMed  Google Scholar 

  5. Nissan S, Bar-Maor JA, Levy E. Anorectal myomectomy in the treatment of short segment Hirschsprung's disease. Ann Surg 1969;170:969–77.

    PubMed  Google Scholar 

  6. Fisher SE, Keighley MR, Breckon K, Smart V, Andrew H. Do patients with disordered defaecation have a primary personality disorder? Gut 1987;28:A1373.

    Google Scholar 

  7. Preston DN, Lennard-Jones JE. Severe chronic constipation of young women: “idiopathic slow transit constipation.” Gut 1986;27:41–8.

    PubMed  Google Scholar 

  8. Jones PN, Lubowski DZ, Swash M, Henry MM. Is paradoxical contraction of puborectalis muscle of functional importance? Dis Colon Rectum 1987;30:667–70.

    PubMed  Google Scholar 

  9. Bartolo DC, Roe AM, Locke-Edmunds JC, Virjee J, Mortensen NJ. Flap-valve theory of anorectal continence. Br J Surg 1986;73:1012–4.

    PubMed  Google Scholar 

  10. Bannister JJ, Gibbons C, Read NW. Preservation of faecal continence during rises in intraabdominal pressure: is there a role for the flap valve? Gut 1987;28:1242–5.

    PubMed  Google Scholar 

  11. Barnes PR, Hawley PR, Preston DM, Lennard-Jones JE. Experience of posterior division of the puborectalis muscle in the management of chronic constipation. Br J Surg 1985;72:475–7.

    PubMed  Google Scholar 

  12. Kamm MA, Hawley PR, Lennard-Jones JE. Lateral division of the puborectalis muscle in the management of severe constipation. Br J Surg 1988;75:661–3.

    PubMed  Google Scholar 

  13. Keighley MR, Shouler P. Outlet syndrome: is there a surgical option? J R Soc Med 1984;77:559–63.

    PubMed  Google Scholar 

  14. Kamm MA, Hawley PR, Lennard-Jones JE. Outcome of colectomy for severe idiopathic constipation. Gut 1988;29:969–73.

    PubMed  Google Scholar 

  15. Preston DN, Lennard-Jones JE. Anismus in chronic constipation. Dig Dis Sci 1985;30:413–8.

    PubMed  Google Scholar 

  16. Hallan RI, William NS, Melling J, Waldron DJ, Womack NR, Morrison JF. Treatment of anismus in intractable constipation with botulinum A toxin. Lancet 1988;2:714–6.

    PubMed  Google Scholar 

  17. Bleijenberg G, Kuijpers HC. Treatment of the spastic pelvic floor syndrome with biofeedback. Dis Colon Rectum 1987;30:107–11.

    Google Scholar 

Download references

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Read at the meeting of The American Society of Colon and Rectal Surgeons, Toronto, Canada, June 11 to 16, 1989, and at the Tripartite Meeting, Birmingham, England, June 19 to 21, 1989.

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Pinho, M., Yoshioka, K. & Keighley, M.R.B. Long-term results of anorectal myectomy for chronic constipation. Dis Colon Rectum 33, 795–797 (1990). https://doi.org/10.1007/BF02052329

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  • DOI: https://doi.org/10.1007/BF02052329

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