Evaluation of the outcomes of Duhamel procedure to treat megarectum in children with functional constipation

Functional constipation (FC) is a common problem in childhood. It is estimated that 0.7 to30 percent of children suffer from CF all over the world. However, if the conservative treatments had no effects on constipation or symptoms are lasted for several years' surgery could be suggested. Unfortunately, there is no international standard definition of what failure of medical treatment actually means and to the surgeons and gastrointestinal (GI) physicians, this may not be the same in different centers.

This is a descriptive-analytical study which was done in Isfahan University of Medical Science, Isfahan, Iran, 2020. The aim was evaluation of outcomes of Duhamel operation in treating the children with megarectum suffering FC who admitted to Imam Hossein Hospital. Data were collected through a 3-part checklist. The first part was about demographic data such as age, gender, age of operation, and use of drugs before and after operation. Part 2 was Rintala-hall scoring system and part 3 was PICS for constipation.

In this study 40 children with FC suffering megarectum were studied and 38.1 percent (15) of children were boys. The mean± SD age of operation was 5.85± 2.92 years. The mean± SD score of incontinence were 10.85± 2.26 and 14.00± 2.38 before and after Duhamel, respectively. The mean score of constipation was 18.20± 3.00 before and 20.50± 2.39 after Duhamel. Paired t test showed that the mean score of incontinence and constipation were different significantly in 3, 6, 12 months after surgery (p< 0.05). So Duhamehh surgery can be concerned good method to treat megarectum due to FC.

Our findings indicated that Duhamel operation could help reliving the sign and symptoms of constipation and fecal incontinence in FC children.