الفهرس 
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Abstract
As many studies that have been published reported results of outcome differences between these two procedures (Myectomy and Botox injection) in patients with IAS achalasia or patients with chronic Idiopathic Constipation, we performed this study to find important outcome differences between these two procedures in treatment of obstructive symptoms after Surgery for Hirschsprung Disease in children.
30 pediatric patients diagnosed with obstructive symptoms after surgical treatment of Hirschsprung’s disease were involved in our study and they were classified into two equal groups as follows:
1. group A (15) patients for internal anal sphincter Myectomy.
2. group B (15) patients for Botox injection in the internal anal sphincter.
Patients showed no statistically significant difference between the two groups regarding any of the comparative terms.
As regard the follow up all patients were submitted to a questionnaire based on what was published by El-Sawaf et al in 2007 at1month & 3 months post-operative.
In this study, there was no statistically significant difference between the two groups (Myectomy and Botox injection) as regards OBS score at 1month post-operative and at 3months post-operative in cases with obstructive symptoms after surgery for Hirschsprung disease in Children, but there was statistically significant difference between the OBS score at 1 month post-operative and OBS score at 3 month post-operative in both group A (Myectomy) and group B (Botox injection).
There were no complications in both groups.
Additional studies with more patients are invited to consolidate the results of the present study.
In conclusion, in the present prospective, randomized, comparative study; Botulinum toxin injection into the IAS is equally effective to Myectomy of the IAS in the treatment of obstructive symptoms after Surgery for Hirschsprung Disease in Children.