Role of rectal myomectomy in refractory chronic constipation

Redkar, Rajeev; Mishra, Pankaj Kumar; Thampi, Chandralekha; Mishra, Shachi

doi:10.4103/0189-6725.104720

Cited by 8 publications

(16 citation statements)

References 16 publications

(28 reference statements)

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“…In the study by Scobie and Mackinlay, normal bowel movements were seen in all children who had underwent myectomy due to ultrashort segment Hirschsprung's disease (17) . Result of the present study was similar to Redkar et al (14) and Freeman (4) studies. Krivchenia et al studied effect of rectal myectomy in treatment of chronic constipation.…”

Section: Resultssupporting

confidence: 82%

“…In this study ganglion cell was absent in 41 cases, which 9 cases had proximal ganglion cell. In Redkar et al study, 10 cases had aganglionosis and 5 of them had proximal ganglion cell (14) . The rate of absent of ganglion cell was higher than Redkar et al study.…”

Section: Resultsmentioning

confidence: 99%

“…This difference may be due different inclusion criteria. In Redkar et al study, children with 1 month treatment for constipation that was not responsive were included (14) , but in this study, children with failure to 6 months treatment were included.…”

Section: Resultsmentioning

confidence: 99%

“…Redkar et al in their study on 28 children age 11 months to 9 years showed anorectal myectomy had 93% good response. Duration of follow up was 6 months to 5 years (14) . In this study the mean time of treatment before myectomy was 14.90±10.31 (ranged 6-48 months) which was significantly higher than Redkar et al study (14) which 1 month was considered for refractory constipation.…”

Section: Resultsmentioning

confidence: 99%

“…Duration of follow up was 6 months to 5 years (14) . In this study the mean time of treatment before myectomy was 14.90±10.31 (ranged 6-48 months) which was significantly higher than Redkar et al study (14) which 1 month was considered for refractory constipation. In the study by Mousavi et al, mean duration of constipation before treatment was 28.4 months (range:3-71 months) (11) .…”

Section: Resultsmentioning

confidence: 99%

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Results of Posterior Myectomy for the Treatment of Children With Chronic Constipation

Peyvasteh

Askarpour

Talaiezadeh

et al. 2015

Arq. Gastroenterol.

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-Background and Objectives -The aim of this study was to evaluate the result of posterior myectomy in children with chronic constipation who underwent to this surgery. Methods -Forty eight children with chronic constipation who did not respond to diet, laxative, or enema were included. Children with abnormal barium enema showing transitional zone were excluded. Children with documented metabolic disease diabetes, and hypothyroidism were also excluded. All patients underwent posterior myectomy. Children were followed during 1 year after surgery regarding frequency of fecal evacuation, fecal consistency, straining during defecation, and diameter of feces. Data was analyzed using SPSS version 13.0 (Chicago, IL, USA). Results -Of 48 cases that underwent surgery, 21 were male and 27 were female. Age range was 1.5 to 11 years old. Mean duration of constipation before surgery was 22.79±17.08 (range 6-48 months). Mean duration of medical treatment was 14.90±10.31 (range= 6-48 months). Fecal consistency, feces diameter, number of bowel movements and straining during defecation were compared before and after surgery. The results were statistically significant (P<0.001). Of all cases, 52% continued treatment of constipation after surgery for 1 year. Ganglion cells were absent in 32 cases. Ganglion cells were present in seven children. Proximal ganglion cell was found in nine cases Treatment response was not different between cases according to status of ganglion cell in biopsy. Conclusion -Fecal consistency, feces diameter, number of bowel movements, and straining for defecation were improved after posterior myectomy. Another study with more sample is required for better evaluation of treatment. HEADINGS -Anal canal. Constipation. Fecal incontinence. Hirschsprung disease.Declared conflict of interest of all authors: none Disclosure of funding: no funding received

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Section: Resultssupporting

confidence: 82%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Results of Posterior Myectomy for the Treatment of Children With Chronic Constipation

Peyvasteh

Askarpour

Talaiezadeh

et al. 2015

Arq. Gastroenterol.

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

Hashish¹,

Elsawaf²

2017

Annals of Pediatric Surgery

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How do we define therapy-resistant constipation in children aged 4–18 years old? A systematic review with meta-narrative synthesis

Sinopoulou,

Gordon,

Rajindrajith

et al. 2024

bmjpo

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BackgroundTherapy-resistant constipation often is a frustrating clinical entity recognised by the persistence of infrequent and painful bowel movements faecal incontinence and abdominal pain despite intensive treatment. It is important to clearly define therapy-resistant constipation before children are subjected to invasive diagnostic and therapeutic procedures.AimTo conduct a systematic review determining how paediatric interventional studies define therapy-resistant constipation.MethodWe searched CENTRAL, MEDLINE, Embase, WHO ICTR and ClinicalTrials.gov. Studies that included patients with therapy-resistant constipation were identified. Data were extracted on criteria used for defining therapy-resistant constipation and reported using a meta-narrative approach highlighting areas of convergence and divergence in the findings.ResultsA total of 1553 abstracts were screened in duplicate, and 47 studies were included in the review. There were at least seven definitions used in the paediatric literature to define medically resistant constipation. The term intractable was used in 24 articles and 21 used the term refractory to describe therapy-resistant constipation. Out of them, only 14 articles have attempted to provide an explicit definition including a predefined time and prior therapy. There were 10 studies without a clear definition for therapy-resistant constipation. The duration before being diagnosed as therapy-resistant constipation varied from 1 months to 2 years among studies. Seven studies employed the Rome criteria (Rome III or Rome IV) to characterising constipation while five adopted the Rome III and European and North American paediatric societies definition of paediatric gastroenterology, hepatology and nutrition guideline of management of constipation in children.ConclusionThe current literature has no explicit definition for therapy-resistant constipation in children. There is a need for a detailed consensus definition to ensure consistency of future research and to avoid unnecessary and maybe even harmful, invasive diagnostic and therapeutic interventions.

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Role of rectal myomectomy in refractory chronic constipation

Cited by 8 publications

References 16 publications

Results of Posterior Myectomy for the Treatment of Children With Chronic Constipation

Results of Posterior Myectomy for the Treatment of Children With Chronic Constipation

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

How do we define therapy-resistant constipation in children aged 4–18 years old? A systematic review with meta-narrative synthesis

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