study of outcome and complications of anorectal myectomy in children with ultrashort segment hirschsprung’s disease

the term ultra short is not clearly defined in ultrashort-segment hirschsprung’s disease. the limited extent of the ultrashort-segment hirschsprung’s disease allows for treatment with extended sphincteromyectomy. in anal sphincter achalasia, anal sphincter dilatation under general anesthesia may be sufficient to treat the condition; in cases with persistent constipation, sphincteromyectomy is indicated. some investigators believe that the term ultrashort-segment hirschsprung’s disease and anorectal achalasia are the same. our study was performed to define the efficacy of transanal anorectal ‎myectomy and digital dilation under general anesthesia in children with ultra short-segment hirschsprung’s disease and internal anal sphincter achalasia. a total of 87 patients were included in our study. among these, 15 cases (17.24%) were female and 72 (82.76%) were male. in 12 patients (13.79%), the muscle strip had normal ganglion cells in both distal and proximal ends (group a). in 10 patients (11.49%), there was not any ganglion cell in both distal and proximal ends of muscle strip (group b). in 65 patients (74.71%), there were normal ganglion cells in proximal end with no ganglion cell in distal end of the muscle strip (group c). ‎there was no meaningful differences between group a, b and c in their outcome and partially or complete response to anorectal myectomy. we recommend the term “sluggish rectum” for these patients instead of ultrashort-segment hirschsprung’s disease or internal anal sphincter achalasia that causes ambiguity in diagnosis and treatment of these cases.