Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

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

Anna Maria Caruso
* ORCID logo ,
Denisia Bommarito
,
Vincenza Girgenti
,
Glenda Amato
,
Ugo Calabrese
,
Adele Figuccia
,
Fabio Baldanza
,
Francesco Grasso
,
Emanuela Giglione
,
Alessandra Casuccio
ORCID logo ,
Mario Pietro Marcello Milazzo
,
Maria Rita Di Pace
Version 1 : Received: 16 May 2023 / Approved: 16 May 2023 / Online: 16 May 2023 (10:48:55 CEST)

A peer-reviewed article of this Preprint also exists.

Caruso, A.M.; Bommarito, D.; Girgenti, V.; Amato, G.; Calabrese, U.; Figuccia, A.; Baldanza, F.; Grasso, F.; Giglione, E.; Casuccio, A.; Milazzo, M.P.M.; Di Pace, M.R. Evaluation of Anal Sphincter with High Resolution Anorectal Manometry and 3D Reconstruction in Patients with Anorectal Malformation. Children 2023, 10, 1037. Caruso, A.M.; Bommarito, D.; Girgenti, V.; Amato, G.; Calabrese, U.; Figuccia, A.; Baldanza, F.; Grasso, F.; Giglione, E.; Casuccio, A.; Milazzo, M.P.M.; Di Pace, M.R. Evaluation of Anal Sphincter with High Resolution Anorectal Manometry and 3D Reconstruction in Patients with Anorectal Malformation. Children 2023, 10, 1037.

Abstract

Background: Children with anorectal malformation (ARM) require long-term follow-up, especially for fecal continence and main predictors of longer-term success are the type of ARM, associated anomalies and sacral integrity. Three-Dimensional High Resolution Anorectal Manometry (3D-HRAM) provides an image of the pressure profile of anal sphincter complex. Aim of study was to evaluate the anal sphincter function in ARM patients with 3D HRAM correlating this analysis to clinical outcome and to associated malformations. Methods: Forty ARM patients, were submitted to 3D HRAM: manometric, anatomical and clinical score were correlated to response to bowel management (BM). Results: A positive correlation between all scores and type 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 do not achieve good continence. Conclusions: 3D-HRAM provides information on the functional anatomy of the sphincter complex. Our study shows good correlation between the manometric results and clinical outcome, confirming spinal malformations and ARM type as most important prognostic risk factors for poor outcome. Specific sphincteric defects can be explored with manometry, allowing for tailored bowel management strategies.

Keywords

anorectal malformations; high resolution anorectal manometry; fecal incontinence; bowel management

Subject

Medicine and Pharmacology, Pediatrics, Perinatology and Child Health

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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