Summary
A total of 82 patients were assessed by rectal manometry after operation for Hirschsprung’s disease according to the Soave-Denda technique. A positive rectoanal reflex was obtained in 32 cases (39%), whereas the remaining 50 cases (61%) did not exhibit a rectoanal reflex. Among the children examined, 72% showed normal rhythmic activity of the anorectum. Anorectal function tended to increase over the years, 90% having good continence 10 years or more after Operation. Patients who encountered postoperative complications had poor continence since such complications may have damaged the levator and sphincter muscles.
Zusammenfassung
82 Kinder mit M. Hirschsprung wurden mittels rektaler Manometrie nach Soave-Denda-Operation nachuntersucht. Bei 32 Fällen (39%) fand sich ein positiver rektoanaler Reflex, während ein solcher bei den restlichen 50 Kindern (61%) nicht nachweisbar war. 72% der Kinder wiesen normale rhythmische Aktivität des Anorektums auf. Die anorektale Funktion zeigte eine Tendenz, sich über die Jahre zu verbessern, wobei 90% der Kinder eine gute Kontinenzleistung nach 10 Jahren und später hatten. Patienten mit postoperativen Komplikationen zeigten schlechte Kontinenz, da diese Komplikationen die Levator- und Sphinktermuskulatur beschädigt hatten.
Résumé
82 enfants atteints de la maladie de Hirschsprung ont été examinés par manométrie rectale après une opération selon Soave-Denda. Dans 32 cas, soit 39%, on a trouvé un réflexe recto-anal positif alors que chez les 50 autres enfants, soit 61%, on n’a pas pu prouver la présence d’un réflexe recto-anal. L’activité rythmique de l’anorectum était normale chez 72% des enfants. La fonction anorectale tendait nettement à s’améliorer à la longue et 90% des enfants avaient retrouvé une bonne continence 10 ans et plus après l’intervention. Les patients chez lesquels des complications post-opératoires étaient survenues présentaient aussi une mauvaise continence, ces complications ayant atteint le releveur et la musculature du sphincter.
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© 1989 Springer-Verlag Berlin Heidelberg
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Morikawa, Y., Matsufugi, H., Hirobe, S., Yokoyama, J., Katsumata, K. (1989). Motility of the Anorectum After the Soave-Denda Operation. In: Yokoyama, J., Angerpointner, T.A. (eds) Constipation and Fecal Incontinence and Motility Disturbances of the Gut. Progress in Pediatric Surgery, vol 24. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-74493-8_8
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DOI: https://doi.org/10.1007/978-3-642-74493-8_8
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