Surgery for idiopathic megarectum and megacolon

Abstract

Many patients with IMM can be managed successfully with laxatives. In a few surgery is required. A subtotal colectomy with ileorectal anastomosis is the operation of choice if the bowel is not too dilated, with a good outcome in approximately 80% of patients. In those with a grossly dilated rectum, a Duhamel procedure is a reasonable alternative, but the results are not as satisfactory. A left iliac colostomy formed above the dilated bowel is an acceptable option for those patients happy to live with a stoma. Distal resection with coloanal anastomosis, or restorative proctocolectomy, are experimental procedures whose roles are yet to be defined. The selection of the right operation for the r..