By G. Heberer (auth.), Prof. Dr. med. Georg Heberer, Priv.-Doz. Dr. med. Heiko Denecke (eds.)
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3 show the results of this investigation compared with the early and late results of 5149 children ill larger 'series collected from the literature (Joppich 1981). In Rehbein's deep anterior resection anastomotic stricture and chronic constipation were the most frequent complications. The constipation in this technique is generally caused by a too long residual aganglionic segment (Fig. 2) or by anal sphincter achalasia (Fig. 3). 5% of the children in order to further weakening of the internal anal sphincter.
Irregular cycles of slow waves and missing spike potentials on the top of the waves 39 Histochemical Results Histochemical studies of suction biopsies in these patients revealed an increased acetylcholinesterase staining in the sphincteric area as Schweizer has shown before (Schweizer et al. 1980), but also fibrotic areas, which are probably responsible for the postoperative impairment of the internal anal sphincter relaxation. Discussion At the present moment there is no explanation for the appearance of new internal sphincter relaxation after the operative procedure for Hirschsprung's disease.
Encopresis was observed in four of 32 patients. Our experience thus confirms the results of the international series of follow-up examinations. References Duhamel B (1960) A new operation for the treatment of Hirschsprung's disease. Arch Dis Child 35:38 Hecker WC (1975) Die Eingriffe in der Bauchhohle im Neugeborenen-, Sauglings- und Kindesalter. In: Zenker R, Berchtold R, Hamelmann H (eds) Die Eingriffe in der Bauchhohle. Prog Pediatr Surg 5: 3 7 Holschneider AM, et al. (1980) Clinical and electromanometrical investigations of postoperative continence in Hirschsprung's disease.