Pickrell procedure in fecal incontinence secondary to anal atresia in children.

Study aim: The aim of this study was to report the results of unilateral Pi ckrell procedure in children with fecal incontinence secondary to anal atre sia. Patients and method: Twenty three children were operated between 1975 and 1 997. The mean age at the time of the operation was 8.5 years. Functional re sults were systematically evaluated by Kelly's clinical score and by anal s phincter electromyography and anal manometry for some patients. Results: There was no postoperative mortality. One colostomy was performed for recurrent local sepsis, The functional result with a mean follow-up of 6 years was estimated to be good in 25%, intermediate in 45% and poor in 30 %. Clinical improvement of continence was obtained in 70% of cases. Conclusion: The improvement of continence after Pickrell procedure essentia lly depends on the patient selection criteria, pre- and postoperative rehab ilitation and regular enemas. In the case of poor results, the authors prop ose bilateral Pickrell procedure which improved the results in eight out of nine children in this group. (C) 2000 Editions scientifiques et medicates Elsevier SAS.