[Interest of the sphincteromyectomy in the treatment of idiopathic constipation and short-segment Hirschsprung's disease (author's transl)].

During last 10 years, 33 children presenting with a severe constipation (19 of them with subobstruction episodes) have been treated with sphincteromyectomy at ages varying from 3 m. to 13 y. The aetiologic study of the constipation includes a barium enema, a manometric study (for the cases treated since 1975) and a histologic study of the muscular strip obtained during the sphincteromyectomy. The barium enema does not show any specific pattern of Hirschsprung's disease, on the other hand, the manometric study brings more constant arguments to distinguish the idiopathic constipation from the short-segment Hirschsprung's disease. The sphincteromyectomy is done by anal approach (28 times) or by posterior approach (6 times). One patient has had 2 sphincteromyectomies. 14 patients had a Hirschsprung's disease and we find among them 9 very good or good results. 5 failures needed a rectal resection by the Swenson's technique. 19 children had an idiopathic constipation. 2 have not been reviewed. Among the 17 others, we find 11 very good results. No postoperative complications have been observed particularly not any incontinence.