Journal of Gastrointestinal & Digestive System
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The purpose of this investigation is to evaluate anorectal function after definitive surgery for Hirschsprung's disease
(HD) by anorectal manometry.
Materials and Methods:
We evaluated the anorectal manometric assessment of 18 children who were operated for HD. Functional
outcomes were determined by a questionnaire. Rectoanal inhibitory reflex (RAIR) and maximum anal resting pressure (MARP)
were monitored. The results were compared between obstructive patients and asymptomatic patients.
The median age at definitive operation was 19 months (range 12-72 months). Anorectal manometry was performed
in 14 male and 4 female patients. All the cases underwent three staged procedure for HD and modified Duhamel procedure
was performed as definitive procedure for all the patients. Mean age was 4.3 months (range 25 days to 5 years) at time of
diagnosis. Post-operative enterocolitis or severe constipation was observed in seven patients (38.8%). There were no patients with
incontinence. Eighteen patients underwent anorectal manometry meanly 2 years after definitive operation. RAIR was absent in
14 (77.7%) patients and abnormal in 4 (22.2%). There were no significant differences in the MARP values between symptomatic
and asymptomatic patients.
The results of our study showed that the majority of the patients have impaired anorectal motility. There were no
significant differences in the results of the functional studies for the seven patients with symptoms of obstruction or constipation
when compared with asymptomatic patients after surgery for HD.
Suzi Demirbag has completed his M.D. at the age of 23 years from Gulhane Military Medical School and postdoctoral studies from same center. He
has published more than 35 papers in reputed journals.
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