Senel Emrah, Demirbag Suzi, Tiryaki Tugrul, Erdogan Derya, Cetinkursun Salih, Cakmak Ozden
Department of Pediatric Surgery, Diskapi Children Hospital, Ankara, Turkey.
Pediatr Int. 2007 Apr;49(2):210-4. doi: 10.1111/j.1442-200X.2007.02342.x.
Fecal incontinence is a common problem after reconstructive surgery for anorectal malformations. The aim of this study was to investigate the effectiveness of clinical scores and anorectal manometry in patients, who have been operated on for anorectal malformations.
In total, 18 patients who underwent surgery for anorectal malformation between 1999 and 2004 were investigated for anal continence. For the assessment of the patients' continence, Kelly's clinical scoring, Kiesewetter-Chang scoring, and anorectal manometry were used.
In the intermediate level anorectal malformations, average anal resting pressure was found as 58.16 +/- 8.14 cmH(2)O and in high level anorectal malformations was found as 40.16 +/- 17.4 cmH(2)O. In the continence score, good according to Kelly and Kiesewetter-Chang scoring systems was an average anal resting pressure value of 57.92 +/- 8.57 cmH(2)O and in fair or bad was found as 32 +/- 12.83 cmH(2)O. There were significant differences between the scoring systems anorectal malformation level, and average anal resting pressure values (P < 0.05).
Anorectal manometric evaluation of the patients in postoperative period with anorectal malformation can give more realistic information about the patient continence status in anorectal malformations.
大便失禁是肛门直肠畸形重建手术后的常见问题。本研究的目的是调查临床评分和肛门直肠测压在接受肛门直肠畸形手术患者中的有效性。
总共对1999年至2004年间接受肛门直肠畸形手术的18例患者进行了肛门节制情况调查。为评估患者的节制情况，采用了凯利临床评分、基泽韦特-张评分和肛门直肠测压。
在中度肛门直肠畸形中，平均肛门静息压为58.16±8.14cmH₂O，在高度肛门直肠畸形中为40.16±17.4cmH₂O。在节制评分中，根据凯利和基泽韦特-张评分系统，良好的平均肛门静息压值为57.92±8.57cmH₂O，一般或较差的为32±12.83cmH₂O。评分系统、肛门直肠畸形程度和平均肛门静息压值之间存在显著差异（P<0.05）。
对肛门直肠畸形术后患者进行肛门直肠测压评估，可以提供关于肛门直肠畸形患者节制状态更真实的信息。
