Three dimension high‐definition manometry in evaluation of anorectal function in 104 normal infants and children: A clinical study from China

Abstract

Anorectal manometry (ARM) is a noninvasive and repeatable diagnostic test for the quantitative evaluation of anorectal function. 1 It has been widely used in the diagnosis of Hirschsprung's disease (HD), 2,3 functional constipation, 4-6 and the evaluation of patients after anorectal surgery. [7][8][9] It is well known that there is rapid body growth between infancy and childhood; however, neither the physiological or functional development of the anorectal canal during this period is well understood, and the reference values for pediatric manometry are remain to be validated. Previous research 10,11 studied the relationship between anal function and age, but no consistent

Using 3D High-Definition Manometry Evaluating Anal Canal Functions in Children with Congenital Anorectal Malformations: Clinical Studies from China

“…In manometric examination, non-operative CON were divided into four groups based on age: ≤1 month, 1-12 months, 1-4 years, and > 4 years. The rules of age grouping were quoted from our previous study [7] and those of others. The age divisions of less than 1 month and 1 month to a year were selected in accordance with Kumar's study [8], while the next dividing age four was originated from the Rome IV questionnaire [9].…”

“…When the proximal and distal ends of the high-pressure zone were established with the aid of the Smartmouse™, the following parameters were collected: (1) the length of the anorectal high-pressure zone (HPZ-length); (2) the mean resting pressure (HPZ-rest); (3) the mean squeeze pressure (HPZ-sqze), via measuring passive contractions induced by applying perianal pricks in patients under 4 years of age and voluntary contraction in those older than 4; (4) recto-anal inhibitory reflex (RAIR), RAIR was considered positive when a decrease of 25% or more in the resting pressure was achieved; (5) the strength distribution of the anal canal, as shown in Video 1 (https://bit.ly/3IkMJxs), in which the anal pressure and strength distribution could be viewed and calculated in the 2D topographic color plot of all pressure transducers when the 3D column plot was cut along the anterior line. Detailed anorectal manometry procedures can be quoted from our previous study [7]. All procedures were performed by the same registered nurse, and the results were analyzed by two senior physicians.…”

Three dimension high definition manometry evaluated postoperative anal canal functions in children with congenital anorectal malformations

“…A manometric exam was repeated in those with poor bowel function when the patient grew up or after conservative management. During the same period, 71 children from our previous study were selected as the agematched non-operative control groups (7). The selection criteria of this group were as follows: children without the organic anorectal disease (e.g., Hirschsprung's disease) identified by imaging and rectal mucosal biopsy; children without diagnosed functional constipation; children without spinal or vertebral deformity; children without anorectal or spinal surgery.…”

“…Based on the age at examination, patients were divided into three groups (3-12 months, 1-4 years, and >4 years). The basis of age grouping is quoted from our previous study and the others (7)(8)(9). This study was approved by the Medical Ethics Committee of Beijing Children's Hospital (2018-K-129), and the requirement for informed patient consent was waived.…”

“…When the proximal and distal ends of the high-pressure zone were established, the length and the mean pressure were calculated with the aid of the Smartmouse TM and the implemented software algorithm. Detailed anorectal manometry procedures can be quoted from our previous study (7).…”