Radiology department, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China.
Department of Neonatal Surgery, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China.
Pediatr Surg Int. 2024 Apr 10;40(1):104. doi: 10.1007/s00383-024-05691-3.
Children with congenital anorectal malformation (CAM) experience challenges with defecation. This study aims to assess defecation in preschool-age children with CAM and to evaluate the correlation between pelvic floor muscle developed assessed by magnetic resonance imaging (MRI) and postoperative defecation.
We collected clinical data and MRI results from 89 male children with CAM. The bowel function scores for children with Perineal (cutaneous) fistula, Rectourethral fistula(Prostatic or Bulbar), and Rectovesical fistula were computed. MRI scans were subjected to image analysis of the striated muscle complex (SMC). The association between pelvic floor muscle score and bowel function score was examined using the Cochran-Armitage Trend Test.
We observed that 77.4% of the SMC scores by MRI for Perineal fistula were good. The Rectourethral fistula SMC score was 40.6% for moderate and 59.4% for poor. The SMC score for Rectovesical fistula was 100% for moderate. Furthermore, 77.4% of patients with Perineal fistula had bowel function scores (BFS) ≥ 17 points. Among those with Rectourethral fistula and Rectovesical fistula, 12.5% and 0 had BFS ≥ 17 points, respectively. An analysis of muscle development and bowel function in patients with Rectovesical fistula, Rectourethral fistula, and Perineal fistula revealed a correlation between SMC development and BFS. Subgroup analysis showed that the Perineal fistula had statistical significance; however, the Rectourethral fistula and Rectovesical fistula were not statistically significant.
A correlation exists between pelvic floor muscle development and postoperative defecation in children with Perineal fistula.
先天性肛门直肠畸形（CAM）患儿存在排便困难。本研究旨在评估学龄前 CAM 患儿的排便情况，并评估 MRI 评估的盆底肌发育与术后排便之间的相关性。
我们收集了 89 例男性 CAM 患儿的临床资料和 MRI 结果。计算了会阴（皮）瘘、直肠尿道瘘（前列腺或球部）和直肠膀胱瘘患儿的排便功能评分。对 MRI 扫描进行横纹肌复合体（SMC）图像分析。采用 Cochran-Armitage 趋势检验分析盆底肌评分与排便功能评分的相关性。
我们发现会阴瘘的 SMC 评分中，77.4%的 MRI 评分良好。直肠尿道瘘的 SMC 评分为中度的 40.6%，为差的 59.4%。直肠膀胱瘘的 SMC 评分为中度的 100%。此外，77.4%的会阴瘘患儿的排便功能评分（BFS）≥17 分。直肠尿道瘘和直肠膀胱瘘患儿中，12.5%和 0%的 BFS≥17 分。对直肠膀胱瘘、直肠尿道瘘和会阴瘘患者的肌肉发育和排便功能进行分析，发现 SMC 发育与 BFS 之间存在相关性。亚组分析显示，会阴瘘有统计学意义；然而，直肠尿道瘘和直肠膀胱瘘没有统计学意义。
会阴瘘患儿的盆底肌发育与术后排便之间存在相关性。
