[Surgical treatment of chronic constipation with megarectum in children].

In this paper, a new operative procedure for patients with chronic constipation with megarectum and its results are presented. Nine cases of idiopathic chronic constipation and one case of short aganglionosis showing megarectum underwent this operation. An incision was placed on the dentate line at 6 o'clock and the internal sphincter muscle was identified. The incision was extended to this muscle. The blunt division between the internal and external sphincter muscles was orally advanced 5 cm from the dentate line. The all layers of anus and lower part of rectum in length of 5 cm were clamped by 2 forceps in width of 1 cm. The mucosal and muscular layers were bilaterally cut in the outer side of the forceps. The rectum on the top of the forceps was pulled through to the dentate line and was anastomosed there; i.e. the posterior part of the anus was replaced by the rectal wall. Bowel habits of operated patients were evaluated at 1 to 3 years after the operation. Complete cure was obtained in 7 cases (including 1 case with aganglionosis). Three cases improved but needed sometimes suppositories. This procedure, sphinctero-myectomy and-plasty may be an operation of choice for chronic constipation with megarectum.