Surgical treatment of total colonic aganglionosis: Efficacy of aganglionic patch enteroplasty in the rat

Goto, Seiichi; Gunter, Michael; Scherer, L.R.; Bloch, Ted; Grosfeld, Jay L.

doi:10.1016/s0022-3468(86)80414-6

Cited by 25 publications

(8 citation statements)

References 18 publications

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“…As noted above, several modifications to the ileoanal pull-through procedure have been made in attempts to improve functional outcomes. Goto and Grosfeld [6] and Goto et al [34] provided the first experimental data supporting the use of an aganglionic patch in rats by showing slowed transit times, improved water and sodium absorption, and favorable anal canal pressures. Furthermore, they showed that the right colon patch was more efficacious than the left.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes in total colonic aganglionosis: a 32-year experience

Escobar

Grosfeld

West

et al. 2005

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Long-term outcomes in total colonic aganglionosis: a 32-year experience

Escobar

Grosfeld

West

et al. 2005

Journal of Pediatric Surgery

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“…However, utilization of the total aganglionic colon does not only bear a higher surgical complication risk but is also associated with a higher incidence of enterocolitis and bowel obstruction, wherefore this technique has been abandoned in several institutions [18][19][20]. Sophisticated research investigations in animal studies and human subjects have shown that the right colon has superior efficiency compared to the transverse and left colon in terms of water and electrolyte absorptive capacities, also leading to a reduced transit time [21][22][23][24][25][26][27][28][29][30]. Thus, the right colonic patch has achieved popularity in TCA surgical management [4][5][6]31].…”

Section: Discussionmentioning

confidence: 99%

Long-term results of total colonic agangliosis patients treated by preservation of the aganglionic right hemicolon and the ileo-cecal valve

et al. 2015

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“…We prefer to discuss the TCA group apart: total colonic aganglionosis is still a major challenge both for surgeons and pediatricians, not only because of the difficulty of an early correct diagnosis (10), but also with respect to the choice of the ideal surgical treatment (6,12). Although the first problem is being solved thanks to the greater awareness worldwide of the disease (11), the latter is still a matter of discussion; since 1968, when Lester Martin presented his procedure (8,9), many centres have used the concept of sparing the aganglionic colon, with various modifications (14), to increase water and electrolyte reabsorption.…”

Section: Discussionmentioning

confidence: 99%

Total Colectomy and Straight Ileo-Anal Soave Endorectal Pull-Through: Personal Experience with 42 Cases

Dodero

Magillo²,

Scarsi³

2001

Eur J Pediatr Surg

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During the period from 1974 to June 2000 we used the straight ileo-anal Soave pull-through to treat 42 patients (24 affected by total colonic aganglionosis [TCA], 10 with ulcerative colitis and 8 with familial polyposis). The aim of this paper is to show that this operation, associated with total colectomy, is highly recommended, causing a lower number of complications when compared to the various "reservoir" techniques. The mean age of the 24 patients with TCA at the time of the pull-through was 2.8 years; in the ulcerative colitis group, it was 14.3 years and in the familial polyposis group 27.2 years. We always used an ileo-anal deferred anastomosis and never performed temporary loop-diverting ileostomy at the time of the pull-through. In the TCA patients we had no immediate or long-term serious post-operative complications: ileal adaptation, after a frequency of 10 - 12 liquid stools a day, showed a gradual, constant and in some cases amazing improvement in all children. Two years after surgery, the mean stool frequency was 3.6 per 24 hours with no significant differences between the 3 main groups; only 4 children still presented with occasional soiling. After pull-through, all children showed normal growth curves in the long term. There was no malabsorption, no serious electrolyte imbalance, no perianal excoriation, no strictures or intestinal obstruction; their quality of life was considered more than satisfactory by the children's families. We have no direct experience with the various ileal "reservoir" techniques for ulcerative colitis and ileal polyposis nor with colon-sparing operations for TCA; as reported in the literature, all these surgical procedures seem to have a higher number of complications such as pelvic sepsis, pouchitis, enterocolitis, etc. compared with our series; we therefore confirm that total colectomy with the straight ileo-anal Soave pull-through is our treatment of choice, as it is simpler to perform and has fewer short- and long-term complications.

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Surgical treatment of total colonic aganglionosis: Efficacy of aganglionic patch enteroplasty in the rat

Cited by 25 publications

References 18 publications

Long-term outcomes in total colonic aganglionosis: a 32-year experience

Long-term outcomes in total colonic aganglionosis: a 32-year experience

Long-term results of total colonic agangliosis patients treated by preservation of the aganglionic right hemicolon and the ileo-cecal valve

Total Colectomy and Straight Ileo-Anal Soave Endorectal Pull-Through: Personal Experience with 42 Cases

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