Department of Surgery, Odense University Hospital, Odense C, 5000, Denmark.
University of Southern Denmark, Faculty of Health Science, Department of Clinical research, Odense C, 5000, Denmark.
Sci Rep. 2020 Apr 7;10(1):6016. doi: 10.1038/s41598-020-62908-w.
Anorectal malformations (ARM) are a spectrum of anomalies of the rectum and anal canal affecting 1 in 2500 to 5000 live births. Functional problems are common and related to the type of ARM and associated malformations. We aimed to evaluate the results of Three-dimensional High Resolution Anorectal Manometry (3D-HRAM) in long-term follow-up after surgical correction of ARM with special reference to fecal incontinence. Twenty-one patients with anorectal malformations and primary repair at our center consented to participate in the study. Pressures of the anal sphincter muscles and defects were addressed by 3D-HRAM. Fecal incontinence and disease-specific quality of life were evaluated by the Fecal Incontinence Quality of Life score and Wexner incontinence score respectively. The study was approved by the Committee in Health Research Ethics and the Danish Data Protection Agency. Median age was 22(12-31) years and 13(67%) participants were females. Sphincter defect was present in 48% (N = 10) of participants. Participants with sphincter defects had significant higher Wexner score and size of sphincter defects and mean anal squeeze pressure were correlated to Wexner score. Participants with or without sphincter defects did not differ on manometry parameters including resting anal and squeeze pressure or disease-specific quality of life. In a study of the long-term outcome after repair of anorectal malformations we found a higher Wexner incontinence score in the presence of an anal sphincter defect and the size of the defect and mean anal squeeze pressure were correlated to the Wexner incontinence score.
肛门直肠畸形（ARM）是一组直肠和肛管的异常，影响 2500 至 5000 例活产中的 1 例。常见的功能问题与 ARM 的类型和相关畸形有关。我们旨在评估三维高分辨率肛门直肠测压（3D-HRAM）在 ARM 手术矫正后的长期随访中的结果，特别关注粪便失禁。我们中心的 21 名肛门直肠畸形患者和初次修复患者同意参与研究。3D-HRAM 解决了肛门括约肌肌肉的压力和缺陷问题。粪便失禁和疾病特异性生活质量分别通过粪便失禁生活质量评分和 Wexner 失禁评分进行评估。该研究得到了健康研究伦理委员会和丹麦数据保护局的批准。中位年龄为 22（12-31）岁，13 名（67%）参与者为女性。48%（N=10）的参与者存在括约肌缺陷。有括约肌缺陷的参与者的 Wexner 评分和括约肌缺陷的大小显著较高，平均肛门收缩压与 Wexner 评分相关。有或没有括约肌缺陷的参与者在静息肛门和收缩压或疾病特异性生活质量等测压参数上没有差异。在一项关于肛门直肠畸形修复后的长期结果的研究中，我们发现存在肛门括约肌缺陷时 Wexner 失禁评分较高，缺陷的大小和平均肛门收缩压与 Wexner 失禁评分相关。
