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Utility of postoperative anorectal manometry in children with anorectal malformation: a systematic review

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Abstract

Children with anorectal malformation (ARM) often continue to have disturbances in bowel function long after reconstructive surgery. Anorectal manometry may be utilized to evaluate bowel function in these children. We aimed to describe the reported protocols and manometric findings in children with ARM post-reconstructive surgery and to investigate the correlation between manometric evaluation and bowel functional outcome. PubMed, EMBASE, and Google Scholar databases were searched from 1980 to 2021. Data were reviewed and extracted independently by two authors, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Included studies were English articles reporting postoperative assessment of children (≤ 18 years) with ARM using anorectal manometry. From 128 articles obtained in the initial search, five retrospective cohort studies and one prospective study fulfilled inclusion criteria. The rectoanal inhibitory reflex and mean anal resting pressure were parameters most often reported to correlate with postoperative bowel function. The least reported parameters among the studies were high-pressure zone, rectal volume, and rectal sensation. Anorectal manometry could be an objective method providing important information for personalized management of postoperative ARM patients with bowel function issues, but lack of standardized protocols limits a comprehensive analysis of their utility.

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References

  1. Nah SA, Ong CCP, Saffari SE, Ong LY, Yap TL, Low Y, Jacobsen AS (2018) Anorectal malformation & Hirschsprung’s disease: a cross-sectional comparison of quality of life and bowel function to healthy controls. J Pediatr Surg 53:1550–1554. https://doi.org/10.1016/j.jpedsurg.2017.08.018

    Article  PubMed  Google Scholar 

  2. Wigander H, Nisell M, Frenckner B, Wester T, Brodin U, Öjmyr-Joelsson M (2019) Quality of life and functional outcome in Swedish children with low anorectal malformations: a follow-up study. Pediatr Surg Int 35:583–590. https://doi.org/10.1007/s00383-018-04431-8

    Article  PubMed  PubMed Central  Google Scholar 

  3. Wang Z, Hu L, Jin X, Li X, Xu L (2016) Evaluation of postoperative anal functions using endoanal ultrasonography and anorectal manometry in children with congenital anorectal malformations. J Pediatr Surg 51:416–420. https://doi.org/10.1016/j.jpedsurg.2015.09.024

    Article  PubMed  Google Scholar 

  4. Kyrklund K, Pakarinen MP, Rintala RJ (2017) Manometric findings in relation to functional outcomes in different types of anorectal malformations. J Pediatr Surg 52:563–568. https://doi.org/10.1016/j.jpedsurg.2016.08.025

    Article  PubMed  Google Scholar 

  5. Keshtgar AS, Athanasakos E, Clayden GS, Ward HC (2008) Evaluation of outcome of anorectal anomaly in childhood: the role of anorectal manometry and endosonography. Pediatr Surg Int 24:885–892. https://doi.org/10.1007/s00383-008-2181-1

    Article  CAS  PubMed  Google Scholar 

  6. Patcharatrakul T, Rao SSC (2018) Update on the pathophysiology and management of anorectal disorders. Gut Liver 12:375–384. https://doi.org/10.5009/gnl17172

    Article  PubMed  Google Scholar 

  7. Thorson AG (2002) Anorectal physiology. Surg Clin N Am 82:1115–1123. https://doi.org/10.1016/s0039-6109(02)00080-4

    Article  PubMed  Google Scholar 

  8. Dinning PG, Carrington EV, Scott SM (2015) The use of colonic and anorectal high-resolution manometry and its place in clinical work and in research. Neurogastroenterol Motil 27:1693–1708. https://doi.org/10.1111/nmo.12632

    Article  CAS  PubMed  Google Scholar 

  9. Rao SS, Azpiroz F, Diamant N, Enck P, Tougas G, Wald A (2002) Minimum standards of anorectal manometry. Neurogastroenterol Motil 14:553–559. https://doi.org/10.1046/j.1365-2982.2002.00352.x

    Article  CAS  PubMed  Google Scholar 

  10. Torresan F, Mandolesi D, Bonventre S, Usai-Satta P (2020) Differences between conventional anorectal manometry and high resolution/high definition anorectal manometry. In: Bellini M (ed) High resolution and high definition anorectal manometry. Springer, Cham, pp 49–68

    Chapter  Google Scholar 

  11. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int J Surg 88:105906. https://doi.org/10.1016/j.ijsu.2021.105906

    Article  PubMed  Google Scholar 

  12. Stang A (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25:603–605. https://doi.org/10.1007/s10654-010-9491-z

    Article  PubMed  Google Scholar 

  13. Kumar S, Al Ramadan S, Gupta V, Helmy S, Debnath P, Alkholy A (2010) Use of anorectal manometry for evaluation of postoperative results of patients with anorectal malformation: a study from Kuwait. J Pediatr Surg 45:1843–1848. https://doi.org/10.1016/j.jpedsurg.2010.04.012

    Article  PubMed  Google Scholar 

  14. Martins JL, Pinus J (1996) Clinical and manometric postoperative evaluation of posterior sagital anorectoplasty (PSARP) in patients with upper and intermediate anorectal malformations. Sao Paulo Med J 114:1303–1308. https://doi.org/10.1590/s1516-31801996000600004

    Article  CAS  PubMed  Google Scholar 

  15. Nagasaki A, Ikeda K, Hayashida Y, Sumitomo K, Sameshima S (1984) Assessment of bowel control with anorectal manometry after surgery for anorectal malformation. Jpn J Surg 14:229–234. https://doi.org/10.1007/BF02469573

    Article  CAS  PubMed  Google Scholar 

  16. Senel E, Demirbag S, Tiryaki T, Erdogan D, Cetinkursun S, Cakmak O (2007) Postoperative anorectal manometric evaluation of patients with anorectal malformation. Pediatr Int 49:210–214. https://doi.org/10.1111/j.1442-200X.2007.02342.x

    Article  PubMed  Google Scholar 

  17. Mert M, Sayan A, Köylüoğlu G (2021) Comparing the fecal continence scores of patients with anorectal malformation with anorectal manometric findings. Pediatr Surg Int 37:1013–1019. https://doi.org/10.1007/s00383-021-04884-4

    Article  PubMed  Google Scholar 

  18. Hedlund H, Peña A, Rodriguez G, Maza J (1992) Long-term anorectal function in imperforate anus treated by a posterior sagittal anorectoplasty: manometric investigation. J Pediatr Surg 27:906–909. https://doi.org/10.1016/0022-3468(92)90395-n

    Article  CAS  PubMed  Google Scholar 

  19. Trajanovska M, King SK, Gibb S, Goldfeld S (2018) Children who soil: a review of the assessment and management of faecal incontinence. J Paediatr Child Health 54:1136–1141. https://doi.org/10.1111/jpc.14173

    Article  PubMed  Google Scholar 

  20. Kim JH (2010) How to interpret conventional anorectal manometry. J Neurogastroenterol Motil 16:437–439. https://doi.org/10.5056/jnm.2010.16.4.437

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Vriesman MH, Koppen IJN, Camilleri M, Di Lorenzo C, Benninga MA (2020) Management of functional constipation in children and adults. Nat Rev Gastroenterol Hepatol 17:21–39. https://doi.org/10.1038/s41575-019-0222-y

    Article  PubMed  Google Scholar 

  22. Strisciuglio C, Banasiuk M, Salvatore S, Borrelli O, Staiano A, Van Wijk M, Vandenplas Y, Benninga MA, Thapar N (2022) Anorectal manometry in children. the update on the indications and the protocol of the procedure. J Pediatr Gastroenterol Nutr 74:440–445. https://doi.org/10.1097/MPG.0000000000003379

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Paediatric and Neonatal Surgery, Department of Surgery, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia

    Suganthi Rajasegaran, Wei Sheng Tan, Anand Sanmugam, Srihari Singaravel & Shireen Anne Nah

  2. Paediatric Surgery Unit, Department of Surgery, University of Malaya Medical Centre, Kuala Lumpur, Malaysia

    Wei Sheng Tan, Don Evana Ezrien, Anand Sanmugam, Srihari Singaravel & Shireen Anne Nah

Authors
  1. Suganthi Rajasegaran
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  2. Wei Sheng Tan
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  3. Don Evana Ezrien
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  4. Anand Sanmugam
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  5. Srihari Singaravel
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  6. Shireen Anne Nah
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Contributions

SR and SAN had full access to all of the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. Study concept and design: SR and SAN; acquisition of the data: SR, TWS, and DEE; Analysis and interpretation of the data: SR, TWS, DEE, AS, and SAN; drafting of the manuscript: SR, DEE, TWS, and SAN; critical revision of the manuscript for important intellectual content: AS, SS, and SAN.

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Correspondence to Shireen Anne Nah.

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The authors did not receive support from any organization for the submitted work. The authors have no relevant financial or non-financial interests to disclose.

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Rajasegaran, S., Tan, W.S., Ezrien, D.E. et al. Utility of postoperative anorectal manometry in children with anorectal malformation: a systematic review. Pediatr Surg Int 38, 1089–1097 (2022). https://doi.org/10.1007/s00383-022-05152-9

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  • DOI: https://doi.org/10.1007/s00383-022-05152-9

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