Low anterior resection with a long posterior anorectal myectomy and sphincterectomy for Hirschsprung's disease

Nine patients with the severe form of Hirschsprung's Disease (HD) underwent low anterior resection with posterior anal myectomy and sphincterectomy. Good results were achieved in six patients. Three patients had bouts of enterocolitis following the surgical treatment which was attributed to residual spasm of the aganglionic rectum and the internal anal sphincter. Myectomy had to be redone in two patients. One patient developed constipation which responded to toilet training. One patient died at home of an unknown cause, and one patient was lost to follow-up. The different methods of treatment of HD are discussed with emphasis on the role of the internal anal sphincter. The relatively high complication rate in this small group of patients does not justify its use in the severe form of HD.