Posterior sagittal anorectoplasty in anorectal anomalies: clinical, manometric and profilometric evaluation.
OBJECTIVE
Anorectal malformations comprise a spectrum of anomalies that continue to be difficult to treat, even today. The aim was to evaluate the fecal continence of children who underwent posterior sagittal anorectoplasty due to anorectal malformations, via computerized anorectal manometry and profilometry.


METHODS
Prospective study at Universidade Federal de São Paulo.


METHODS
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, manometric 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 rectosphincteric 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 predominant, and there was a similar distribution for the continent and partially continent patients. However, among the incontinent patients, green (< 20 mmHg) and blue prevailed.


CONCLUSIONS
Manometric and computerized profilometric analyses were an excellent method for postoperative evaluations on patients with intermediate and high anorectal anomalies, and for therapeutic planning.
Vital Júnior
Pedro Félix
PF
Escola Paulista de Medicina, Discipline of Pediatric Surgery, Universidade Federal de São Paulo, São Paulo, Brazil.
Martins
José Luiz
JL
Peterlini
Fábio Luís
FL
D000293:Adolescent; D000367:Age Factors; D001003:Anal Canal / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005242:Fecal Incontinence / Q000503:physiopathology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007223:Infant; D008297:Male; D008365:Manometry; D009119:Muscle Contraction / Q000502:physiology; D011312:Pressure; D012007:Rectum / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery*; D012021:Reflex, Abnormal / Q000502:physiology; D016896:Treatment Outcome