A new operative approach to total aganglionosis of the colon

Aganglionosis of the entire colon with or without involvement of the small intestine presents special problems in operative management. A new operation is described herein combining the technique of the endorectal pull-through and primary anastomosis with the creation of a reservoir made up of aganglionic right colon and ganglionic small intestine. Decreased fecal fluid and electrolyte losses, and minimization of residual internal sphincter obstruction are advantages of this operation.