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Title of Journal: Pediatr Surg Int

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Abbravation: Pediatric Surgery International

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Springer-Verlag

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DOI

10.1007/978-3-540-75506-7_28

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1437-9813

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Bowel function after surgery for anorectal malform

Authors: Tomoki Tsuda Naomi Iwai Osamu Kimura Yoshihiro Kubota Shigeru Ono Yasunari Sasaki
Publish Date: 2007/10/09
Volume: 23, Issue: 12, Pages: 1171-1174
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Abstract

Tethered spinal cord TC is an anomaly frequently recognized in association with anorectal malformations ARM However the influence of TC on bowel function in children with ARM remains unknown Furthermore there are few studies that have assessed anorectal function in children with ARM and TC The aim of this study was to evaluate anorectal function in ARM patients with TC using clinical assessment and anorectal manometry Among 258 patients with ARM this retrospective investigation included 35 patients who underwent spinal magnetic resonance imaging MRI after surgery for ARM The patients were divided into two groups based on the presence or absence of TC and bowel function was assessed by Kelly’s clinical score and anorectal manometry Tethered cord was found in nine of the 35 patients 26 with ARM Of the ARM patients TC was noted in four of 11 36 with high type anomalies one of 8 13 with intermediate type anomalies two of 14 14 with low type anomalies and two of two patients 100 with cloacal anomalies Kelly’s clinical score did not significantly differ between the two groups However two of the nine patients with TC had poor bowel function Kelly’s score 2–0 points On the contrary patients without TC did not have poor bowel function Anorectal manometry did not show a significant difference between patients with and without TC However the two patients with TC who had poor bowel function by Kelly’s score had low anal resting pressure which was essential for achieving fecal continence In conclusion the present study showed that tethered cord was more frequently found in patients with more severe anorectal anomalies Patients with TC were more likely to have poor bowel function but this did not reach statistical significance

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