Document Detail

Crucial role of rectoanal inhibitory reflex in emptying function after anoplasty in infants with anorectal malformations.
MedLine Citation:
PMID:  15140664     Owner:  NLM     Status:  MEDLINE    
Constipation is a common problem after reconstructive surgery for anorectal malformations. The underlying pathophysiology of the constipation in these patients is unclear. The objective of this study was to compare manometric disturbance in infants with and without post-anoplasty constipation. Anorectal manometry studies were performed within 12 months of anoplasty, as a part of the follow-up protocol, in 24 infants aged less than 3 years who had anorectal malformations. The manometric profiles studied were mean resting anal pressure (ArP), mean resting rectal pressure (RrP), mean resting rectoanal pressure gradient (RRPG), peak squeeze pressure (PSP), and the presence of the rectoanal inhibitory reflex (RAIR). Eight of 24 infants (33%) experienced constipation during the examination period. There was no difference in pressure profiles between low and non-low anomalies. In the non-constipation group, RrP was 5.1 mmHg, ArP was 21.0 mmHg, RRPG was 16.0 mmHg, and PSP was 88.4 mmHg. In the constipation group, RrP was 7.3 mmHg (p = 0.37), ArP was 37.5 mmHg (p = 0.03), RRPG was 3.05 mmHg (p = 0.05), and PSP was 81.7 mmHg (p = 0.77). RAIR was present in 93.75% of cases without constipation and 12.5% of cases with constipation (p < 0.01). One patient who had clinical conversion from constipation to a good result also showed positive conversion of the RAIR. RAIR and anal resting tone play important roles in emptying function. As far as possible, these functions should be preserved during reconstruction.
Surasak Sangkhathat; Sakda Patrapinyokul; Noppawan Osatakul
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Asian journal of surgery / Asian Surgical Association     Volume:  27     ISSN:  1015-9584     ISO Abbreviation:  Asian J Surg     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-05-13     Completed Date:  2004-06-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8900600     Medline TA:  Asian J Surg     Country:  China    
Other Details:
Languages:  eng     Pagination:  125-9     Citation Subset:  IM    
Pediatric Surgery Unit, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand 90110.
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MeSH Terms
Child, Preschool
Constipation / etiology,  physiopathology*
Defecation / physiology*
Digestive System Abnormalities / physiopathology*,  surgery
Digestive System Surgical Procedures / adverse effects*
Rectum / abnormalities,  innervation,  surgery
Reflex / physiology*

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