Objective To evaluate the long-term results of partial internal sphincterectomy for the treatment of internal anal sphincter achalasia in childhood. Methods The clinical,radiographic,manometrical and histochemical data of 6 cases were reviewed retrospectively. All patients had received partial internal sphincterectomy and were followed-up for 2 to 8 years. Results All patients presented with severe constipation with or without soiling. No stenosis zone of intestine could be noted in 3 patients by barium enema examination. The rectoanal inhibition reflex on rectal balloon inflation was absent in all patients. The normal acetylcholinesterase activity on rectal biopsies was demonstrated by histochemical staining. Ganglion cells within internal anal sphincter was noted in all cases. On follow-up,all patients regained regular bowel habits and are not on any laxatives. Conclusion The long term results of partial internal sphincterectomy for the treatment of internal anal sphincter achalasia in childhood are satisfactory.

OBJECTIVETo summarize the experience of heart-shaped anastomosis operation in patients with Hirschsprung's disease.

METHODSHirschsprung's disease treated by heart-shaped anastomosis, improvement of surgery procedure, and complications were reviewed retrospectively.

RESULTSOf 193 cases, 152 completed follow-up. Early complications included urine retention (2 cases), enteritis (10), anastomosis stricture (1), and intestinal obstruction (2). Late complications (22 cases) included adhesive intestinal obstruction (2), constipation (5), incision hernia (2), enteritis (6), and occasionally stool stains (7). Neither infection in celiac, pelvic cavity and wound nor incontinence or death occurred in all patients.

CONCLUSIONHeart-shaped anastomosis procedure can effectively reduce the complications ceased by Hirschsprung's disease operation and is superior to other procedures.

Child ; Child, Preschool ; Female ; Follow-Up Studies ; Gastroenterostomy ; adverse effects ; methods ; Hirschsprung Disease ; surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Postoperative Complications ; etiology ; Retrospective Studies