Short-term outcome of posterior anorectal myectomy for treatment of children with intractable idiopathic constipation

Abstract

Purpose: Many children with idiopathic constipation (IC) fail to improve with bowel management program. The role of surgical treatment in this subset of patients with intractable IC is still controversial. The aim of this study was to assess the outcome of anorectal myectomy in treatment of intractable IC.

Patients and methods: Twenty-five patients with intractable IC were included in this study after failure of bowel management program for at least 1 year. Work-up was made to exclude all other causes of chronic constipation. All patients were selected for internal sphincter myectomy. Patients were followed for at least 6 months postoperatively. Clinical improvement was evaluated by number of bowel motions per week, weaning of laxatives, soiling, child’s own feedback, and overall parent satisfaction.

Results: Study included 25 children with a mean age of 6.3 ±1.6 years, suffering from constipation for a mean of 32.9 ± 8.5 months, with failed trails of bowel management program for at least 12 months. All children were subjected to anorectal myectomy with a mean follow-up of 12.4 months. Children’s feedback showed a mean of 79.1% improvement. Postoperative parent satisfaction had a mean of 75.9%.

Conclusion: Anorectal myectomy is an effective and technically simple procedure in selected patients with intractable IC.

Keywords: anorectal myectomy, children, idiopathic constipation