Shi Chengren, Wang Jun, Yu Shiyao, et al
Department of Pediatric Surgery, Xinhua Hospital, Shanghai Second Medical University, Shanghai, China

Objective: to evaluate the effect of surgical treatment for intestinal innervation disorders and some confusion was raised.
Methods: 32 children with intestinal innervation disorders were treated from September 1990 to September 2000, 24 males, 8 females, mean age 5.28 years (range: 6 days to 13 years). Among them, 17 were combining type, 9 imperforate anus associated with intestinal neuronal dysplasia, 3 immaturity of ganglion cells, 1 hypoganglionosis, 2 neuronal hypogenesis. The treatments included enterectomy, enterostomy and conservative therapy.
Results: Follow-up was acquired in 28 patients (87.4%). The effective rate of surgical treatment is 85.7%, surgery has significant effect on the combining type and imperforate anus associated with intestinal neuronal dysplasia especially. The symptoms were not released in 1 case with total small bowel neuronal dysplasia after partial enteretomy. 3 children with immaturity of ganglion cells underwent colostomy at neonatal period, 6 to 12 months later the second biopsy were showed mature cells, and defecation was normal after the stoma were closed. In 1 hypoganglionosis and 2 neuronal hypogenesis, the second biopsy after 6 to 28 months showed no pathologis change. The results were unsatisfactory in all the rest cases undergoing conservative therapy.
Conclusion: The surgical resection is useful for combining type and imperforate anus associated with intestinal neuronal dysplasia. Conservative therapy has little effect. On our experience it is difficult to evaluate the quality of ganglion cells by intraoperative frozen section, and the immaturity of ganglion cells is transformable. At the same time, some confusion raised here need more investigation.