Evaluation of Anal Sphincter with High Resolution Anorectal Manometry and 3D Reconstruction in Patients with Anorectal Malformation

被引:0
|
作者
Caruso, Anna Maria [1 ]
Bommarito, Denisia [1 ]
Girgenti, Vincenza [1 ]
Amato, Glenda [1 ]
Calabrese, Ugo [1 ]
Figuccia, Adele [2 ]
Baldanza, Fabio [2 ]
Grasso, Francesco [2 ]
Giglione, Emanuela [3 ]
Casuccio, Alessandra [2 ]
Milazzo, Mario Pietro Marcello [1 ]
Di Pace, Maria Rita [2 ]
机构
[1] Childrens Hosp G Cristina ARNAS Civ, Pediat Surg Unit, I-90100 Palermo, Italy
[2] Univ Palermo, Dept Hlth Promot Mother & Child Care, Pediat Surg Unit, Internal Med & Med Special, I-90100 Palermo, Italy
[3] Univ Padua, Womens & Childrens Hlth Dept, Pediat Surg Div, I-35100 Padua, Italy
来源
CHILDREN-BASEL | 2023年 / 10卷 / 06期
关键词
anorectal malformations; high resolution anorectal manometry; fecal incontinence; bowel management; PEDIATRIC FECAL INCONTINENCE; RESONANCE-IMAGING EVALUATION; SPINAL-CORD; CHILDREN; ANOMALIES; OUTCOMES; URINARY; MUSCLE; ABNORMALITIES; INTERMEDIATE;
D O I
10.3390/children10061037
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: Patients with anorectal malformation (ARM) need long-term follow-up, in order to evaluate fecal continence; the main predictors of longer-term success are the type of ARM, associated anomalies and sacral integrity. Three-Dimensional High Resolution Anorectal Manometry (3D-HRAM) gives detailed information on pressure on the anal complex profile. Our objective was to analyze anal sphincter activity in ARM patients with 3D-HRAM establishing the correlation between manometric and clinical data. Methods: Forty ARM patients were submitted to 3D-HRAM: manometric, anatomical and clinical scores were correlated with each other and with the bowel management response (BM). Results: A positive correlation between all scores and types of ARM was found: in high ARM and in patients with spinal anomalies (regardless to ARM type) lower scores were reported and even after BM they did not achieve good continence. Conclusions: 3D-HRAM gives detailed data on the functional activity of the anal sphincter complex. Our study revealed a correlation between manometric parameters and clinical outcomes, confirming spinal malformations and ARM type as the most important prognostic risk factors for a bad outcome. Specific sphincteric defects can also be explored with manometry, allowing for tailored bowel management strategies.
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页数:15
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