Posterior sagittal anorectoplasty in anorectal anomalies: Clinical, manometric and profilometric evaluation

Abstract

Context and Objective: Anorectal malformations comprise a spectrum of anomalies that continue to be difficult to treat, even today. Tha aim was to evaluate local continence of children who underwent pasterior sagittal anorectoplasy due to anorectal malformations, via computerized anorectal monometry and pollometry. Design and setting: Prospective study at Universidade Federal de Sao Paula. Method: 82 patients (56.1% boys;43.9% girls) of mean age 85.5 months were evaluated. They were divided into continent, partially continent and incontinent groups. Age, sex, monometric variables and profilometric parameters were studied. The results were statistically analyzed. Results: Among the 82 patients, 37.8% were continent, 25.6% were partially continent and 36.6% were incontinent. The overall mean resting pressure was 22 mmHg, and the means for the continent, partially continent and incontinent groups were, respectively, 30.7 mmHg, 23 mmHg and 14.7 mmHg. The overall mean pressure response to voluntary contraction was 56 mmHg, and the means for the groups were 65.4 mmHg, 55.8 mmHg and 46.6 mmHg, respectively. The restosphinctoric reflex was absent in 82.9% of the cases. In the profilometry analysis For all patients together, blue (20 to 50 mmHg) and yellow (50 to 80 mmHg) were prelomenant, and there was a similar distribution for the continent and partially continent patients. However, among the incontinent patients, green (<20 mmHg) and the blue prevailed. Concluions: Monometric and computerized profilometric analysis were an excellent method for postoperative evaluation on patients with intermediate and high anorectal anomalies, and for therapeutic planning. Copyright © 2007, Associação Paulista de Medicina.