Hata Y, Shinada Y, Sasaki F, Takahashi H, Uchino J
Chir Pediatr. 1986;27(4):205-8.
The sphinctero-myectomy as a surgical treatment of megarectum has been generally advocated, but its results are not always satisfactory. In this paper, a new surgical treatment will be presented. Ten cases with idiopathic chronic constipation presenting megarectum in barium enema underwent this operation. After anal dilatation, incision was made in width of 2 cm at 6 o'clock on the dentate line. The blunt split between internal and external sphincter muscles was advanced to 6 cm orally. The all layers of superior part of anus and lower part of rectum in length of 5 cm were clumped by two forceps in width of 1 cm. Then the all layers in outer side of forceps were cut bilaterally. The rectum on the top of the forceps was pulled through to the dentate line and was anastomosed there. The operative results were evaluated more than one year after the operation. Complete cure was noticed in 7 cases and marked improvement in 3 cases. Our procedure, named as sphinctero-myectomy and plasty can be operation of choice for chronic constipation with megarectum.
括约肌切除术作为巨直肠的一种外科治疗方法已被广泛提倡，但其结果并非总是令人满意。本文将介绍一种新的外科治疗方法。10例在钡剂灌肠中表现为巨直肠的特发性慢性便秘患者接受了该手术。肛门扩张后，在齿状线6点处做一个2厘米宽的切口。内外括约肌之间的钝性分离向口侧推进6厘米。用两把宽度为1厘米的镊子夹住肛门上部和直肠下部5厘米长的全层。然后双侧切除镊子外侧的全层。将镊子顶端的直肠拉至齿状线并在那里进行吻合。术后一年多对手术结果进行评估。7例完全治愈，3例明显改善。我们的手术方法，称为括约肌切除成形术，可作为巨直肠慢性便秘的首选手术。
