Modified Martin Procedure for Megacystis Microcolon Intestinal Hypoperistalsis Syndrome (MMIHS)

Abstract

Objectives: To evaluate the therapeutic effect of the modified Martin procedure for patients with megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS).

Methods: The authors retrospectively analyzed the medical records of patients diagnosed with MMIHS who underwent surgical treatment at their institute between August 2019 and June 2023. The modified Martin procedure and Bishop-Koop procedure were performed for the patients. Data, including demographics, operative time, intraoperative blood loss, complications and clinical outcomes, were collected.

Results: A total of 11 children with MMIHS were enrolled in this study. The mean age of the patients was 4.08 ± 1.69 y, and seven cases (63.64%) were male. The average operation time was 312.09 ± 108.88 min, with an average intraoperative blood loss of 25.82 ± 6.42 ml. The first postoperative defecation time was 3.60 ± 0.91 d. Patients took an average of 4.10 ± 0.40 d to resume eating after surgery, and their average length of hospital stay was 24.64 ± 4.52 d. Postoperative follow-up results showed that of the nine surviving children, two patients required intermittent intravenous nutrition support, and seven patients had successfully transitioned from parenteral nutrition support. In this study, two patients eventually died of multiple organ failure.

Conclusions: The modified Martin procedure is a promising method for treating MMIHS. The patients exhibited positive nutritional status and satisfactory outcomes during the follow-up period.

Keywords: Bishop–koop; Clinical outcome; MMIHS; Martin.

Fig. 1

(a) Intraoperative picture of terminal ileum and sigmoid colon being anastomosed using endoscopic linear cutters. (b) Schematic representation of the Modified Martin procedure