抄録
Motility of the ano-rectum was studied in 25 children who had undergone rectoplasty with posterior triangular colonic flap for Hirschsprung's disease. The examinations were also carried out in 40 age-matched controls. Postoperative sphincter control was fair in 2, and poor in 20 patients within 6 months after the operation, but good in 5, fair in 6, and poor in 0 in 11 patients at 2 or more years after the operation. Measurements of resting pressure profiles of the anorectum disclosed that higher rectal pressure and decreased basal rhythmic contraction were characteristic of the patients with Hirschsprung's disease. Recto-anal reflex was absent in all the patients. Postoperatively, decrease of rectal pressure, increase of anal canal pressure, increase in length of anal canal, and increase of basal thythmic contraction of anal canal were observed. Recto-anal reflex appeared in 9 out of 11 patients at more than 2 years after the operation. Rectal compliance was markedly less in the patients within 6 months after surgery than in the controls. Increase of rectal compliance was noted thereafter, and there was no significant difference of rectal compliance between the patients at more than 2 years after surgery and the age-matched controls. Mass contraction of the rectum was not observed in the controls and patients before the operation. The contraction was noted in all the patients within 6 months after surgery and in 9 out of 11 patients at more than 2 years after the operation. Observations in cine-defecography and measurements of the mass contraction of the rectum were in accordance in that the motility of the "neorectum" was gradually stabilized after the operation. Improvements of sphincter control of the postoperative patients were considered to be due to; stabilized motility of the neorectum, preservation of sphincter muscles, and maturation of reservoir function.
