Manometric findings in relation to functional outcomes in different types of anorectal malformations

Kyrklund, Kristiina; Pakarinen, Mikko P.; Rintala, Risto J.

doi:10.1016/j.jpedsurg.2016.08.025

Cited by 26 publications

(14 citation statements)

References 31 publications

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“…Mild sacral dysplasia (3-4 segments remaining) may not impact significantly on the prognosis for fecal continence, prevalence of lower urinary tract symptoms, or sexual function according to recent analyses. 16,17,45 The presence of functional IAS on anorectal manometry, as indicated by a positive rectoanal inhibitory reflex (RAIR) postoperatively, has been associated with improved functional outcomes. 29,45 This finding favours conserving the distal part of the fistula in severe ARMs in association with sagittal repairs.…”

Section: Other Important Prognostic Factorsmentioning

confidence: 99%

“…16,17,45 The presence of functional IAS on anorectal manometry, as indicated by a positive rectoanal inhibitory reflex (RAIR) postoperatively, has been associated with improved functional outcomes. 29,45 This finding favours conserving the distal part of the fistula in severe ARMs in association with sagittal repairs. RAIR was preserved in 100% of mild ARMs and 83% of severe ARMs (including 70% of males with RUF after PSARP) in the authors' recent evaluation.…”

Section: Other Important Prognostic Factorsmentioning

confidence: 99%

“…RAIR was preserved in 100% of mild ARMs and 83% of severe ARMs (including 70% of males with RUF after PSARP) in the authors' recent evaluation. 45…”

Section: Other Important Prognostic Factorsmentioning

confidence: 99%

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Long-term bowel function, quality of life and sexual function in patients with anorectal malformations treated during the PSARP era

Kyrklund

Pakarinen

Rintala

2017

Seminars in Pediatric Surgery

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Anorectal malformations are an important group of congenital anomalies that vary widely in their anatomical characteristics and complexity. Understanding the long-term functional outcomes after modern treatments, and how these compare to the general population, are essential for ensuring that patients receive optimal, evidence-based care. With increasing appreciation of the wider impact of the illness on patients and their families, minimizing social disability from fecal incontinence and enabling normal social integration from the outset are key management concerns. This review summarizes the current knowledge on the functional outcomes by type of malformation, reflecting on the literature, and our institutional experience over a follow-up period of nearly 30 years.

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Section: Other Important Prognostic Factorsmentioning

confidence: 99%

Section: Other Important Prognostic Factorsmentioning

confidence: 99%

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Long-term bowel function, quality of life and sexual function in patients with anorectal malformations treated during the PSARP era

Kyrklund

Pakarinen

Rintala

2017

Seminars in Pediatric Surgery

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“…The results have been contradictory and with dubious clinical value. Some studies have found a correlation between the extent of sphincter damage and the degree of continence and others have not 5 . Three-Dimensional High Resolution anorectal manometry (3D-HRAM) is a technique providing an image of the pressure profile of the sphincter complex.…”

mentioning

confidence: 99%

Correlation of anorectal manometry measures to severity of fecal incontinence in patients with anorectal malformations – a cross-sectional study

Bjørsum-Meyer

Christensen

Jakobsen

et al. 2020

Sci Rep

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Anorectal malformations (ARM) are a spectrum of anomalies of the rectum and anal canal affecting 1 in 2500 to 5000 live births. Functional problems are common and related to the type of ARM and associated malformations. We aimed to evaluate the results of Three-dimensional High Resolution Anorectal Manometry (3D-HRAM) in long-term follow-up after surgical correction of ARM with special reference to fecal incontinence. twenty-one patients with anorectal malformations and primary repair at our center consented to participate in the study. pressures of the anal sphincter muscles and defects were addressed by 3D-HRAM. Fecal incontinence and disease-specific quality of life were evaluated by the fecal incontinence Quality of Life score and Wexner incontinence score respectively. the study was approved by the Committee in Health Research Ethics and the Danish Data Protection Agency. Median age was 22(12-31) years and 13(67%) participants were females. Sphincter defect was present in 48% (n = 10) of participants. Participants with sphincter defects had significant higher Wexner score and size of sphincter defects and mean anal squeeze pressure were correlated to Wexner score. Participants with or without sphincter defects did not differ on manometry parameters including resting anal and squeeze pressure or disease-specific quality of life. In a study of the long-term outcome after repair of anorectal malformations we found a higher Wexner incontinence score in the presence of an anal sphincter defect and the size of the defect and mean anal squeeze pressure were correlated to the Wexner incontinence score.

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“…The manometry systems used in different centers were products of the same company (Medical Measurement Systems [MMS]) and the parameters concerned in this study (sphincteric resting / squeezing pressure and anorectal sensation) were measured in the same way among the three centers. Combining the data from two previous studies regarding the manometric findings in pediatric population as well as the values from six age-matched healthy children recruited for another study, the reference values for normal sphincteric resting pressure was 30 mm Hg to 60 mm Hg and squeezing pressure was 50 mmHg to 120 mmHg [8,9]. Anorectal sensation was recorded by distending the balloon with various volume of air.…”

Section: Anorectal Manometrymentioning

confidence: 99%

Are all patients with short segment Hirschsprung’s disease equal? A retrospective multicenter study

et al. 2017

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Patients with short segment HSCR are not equal at all. HSCR patients with aganglionosis limited to the rectum without the need of removing the entire sigmoid colon have a better bowel control and overall functional score. Less bowel loss and colonic dissection maybe the underlying reasons. Although future studies with a larger sample size and a longer follow-up period are required to validate the results of this study, it has provided a new insight to the current understanding of short segment disease in HSCR.

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Manometric findings in relation to functional outcomes in different types of anorectal malformations

Abstract: III.

Cited by 26 publications

References 31 publications

Long-term bowel function, quality of life and sexual function in patients with anorectal malformations treated during the PSARP era

Long-term bowel function, quality of life and sexual function in patients with anorectal malformations treated during the PSARP era

Correlation of anorectal manometry measures to severity of fecal incontinence in patients with anorectal malformations – a cross-sectional study

Are all patients with short segment Hirschsprung’s disease equal? A retrospective multicenter study

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