SURGICAL TREATMENT OF IDIOPATHIC MEGACOLON AND MEGARECTUM

Abstract

The study focuses on surgical treatment of idiopathic megacolon and megarectum. Methods: 36 patients (18-78 years, 20 male) were operated in 2004-2014. 25 (69.4 %) patients had idiopathic megacolon. 11 (30.6 %) patients had idiopathic megarectum with or without megacolon. The choice of surgical procedure depended on extent and localization of megacolon and function of nondilated colon. Left colectomy was performed in 12 (33.3 %) cases, subtotal colectomy and ascendorectal anastomosis - in 13 (36.1 %) cases. All patients with idiopathic megarectum were undergone longitudinal proctoplasty combined with left colectomy or subtotal colectomy. Results: After surgery 1 (2.8 %) patient died and 5 (13.9 %) had complications that required reoperation. In follow up 1 patient have got megacolon recurrence. 9 of idiopathic megarectum patients whom stoma was closed were followed up. There were not megacolon or megarectum recurrence. In 8 (88.9 %) patients were detected significant improvement and satisfaction with surgery. There also was found significant reduction of constipation rate and rectal function improvement. No one patient had sexual or urological impairment. Conclusion: In cases of idiopathic megacolon only dilated colon resection may be justified in selected patients with good function of nondilated colon. Longitudinal proctoplasty leads to significant improvement of rectal function and may be used in idiopathic megarectum surgical treatment.