Surgical Treatment of Refractory Childhood Constipation with Sigmoidectomy and Tapering of Megarectum

Treatment of constipation includes education of child and parents, dietary changes, medication, psychotherapy, behavioral therapy, and eventually surgery. This study is the success rate of surgical treatment in children with chronic idiopathic constipation refractory to routine medical treatment.

The sample consisted of 16 patients, 8 girls and 8 boys, of all children with chronic idiopathic constipation refractory to medical therapy, who were referred to a tertiary center for final surgical plan. The study was descriptive. Data were entered into statistical software spss-18. For data analysis, multiple regression analysis and multivariate analysis of variance was used.

A total of 16 patients were enrolled, half female, and half of the patients were male, mean age was 3.96 ± 2.29 years. The results showed that in 13(81.25%) patients after surgery, the patient's symptoms completely resolved. In 14(87.5%) patients, the use of laxatives was reduced to one time per day except in 1(6.25%) patient, who requiring the use of laxatives. In all patients, frequency of bowel movements increased.Multiple regression analysis showed that age, sex, duration of disease and age less than 5 years have direct significant relationship (P < 0.05) with successful surgical treatment.

Our results show that surgical treatment in refractory chronic functional Constipation which did not respond to medical treatment, leads to better control of disease, increase frequency of defecation, decrease need to laxative and relieving soiling.