Mitrofanoff P, Grise P, Lefort J, Borde J
Chir Pediatr. 1981;22(4):267-71.
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.
在过去10年中，33例严重便秘患儿（其中19例有不全梗阻发作）接受了括约肌切除术，年龄从3个月至13岁不等。便秘的病因学研究包括钡灌肠、测压研究（针对1975年以来治疗的病例）以及括约肌切除术中获取的肌条组织学研究。钡灌肠未显示出任何先天性巨结肠病的特定模式，另一方面，测压研究为区分特发性便秘和短段先天性巨结肠病提供了更具一致性的依据。括约肌切除术通过经肛门途径进行28次，通过后路途径进行6次。1例患者接受了2次括约肌切除术。14例患者患有先天性巨结肠病，其中9例效果非常好或良好。5例失败病例需要采用斯文森技术进行直肠切除。19例儿童患有特发性便秘。2例未进行复查。在其余17例中，11例效果非常好。未观察到术后并发症，尤其是未出现任何失禁情况。
