Anterior resection combined with anorectal myectomy in the treatment of Hirschsprung's disease.

During the period October 1974 to November 1977, six children with Hirschsprung's disease have undergone anorectal myectomy followed by anterior resection. The procedure was carried out in a group of older children who presented late, where the aganglionic segment was thought to be confined to the rectum alone. In these cases, when the initial myectomy specimen revealed total aganglionosis and serial biopsies revealed that the aganglionic segment extended beyond the reach of myectomy, it was decided to carry out anterior resection. The rationale, methods, and results are discussed. It is suggested that this type of procedure is most suitable to those older patients who are diagnosed late, with disease located in the rectum.