KMID : 0812020180240010070
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Korean Journal of Neurogastroenterology and Motility 2018 Volume.24 No. 1 p.70 ~ p.78
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Interest of Anorectal Manometry During Long-term Follow-up of Patients Operated on for Hirschsprung¡¯s Disease
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Tran Viet Q.
Mahler Tania Bontems Patrick Truong Dinh Q. Robert Annie Goyens Philippe
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Abstract
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Background/Aims: Although many advances in the management of Hirschsprung¡¯s disease have recently been achieved, postoperative outcomes of these patients remain difficult in a non-negligible number of cases. Therefore, this study aims at investigating characteristics of anorectal manometry and its relationship with postoperative outcomes during long-term follow-up in Hirschsprung patients.
Methods: Patients over 4 years of age operated on for Hirschsprung¡¯s disease were interviewed to complete detailed questionnaires on bowel function. The patients who consented to undergo an anorectal manometry during follow-up were enrolled in this study. We investigated their clinical characteristics, manometric findings, and their postoperative bowel function.
Results: Nineteen patients out of 53 patients (35.8%) were enrolled, 68.4% who were male. Mean age of patients at manometry was 11.3 ¡¾ 6.3 years. Twelve out of 19 patients (63.2%) were incontinent. The mean anal resting pressures of incontinent patients were significantly lower than continent patients (47 ¡¾ 12 mmHg versus 63 ¡¾ 11 mmHg, P < 0.05, t test). Due to neurological impairment, only 11 patients (57.9%) were able to perform a complete manometry. A dyssynergic defecation was found in 4 patients during strain tests. Maximum tolerated volume of the incontinent patients was significantly lower than that of the continent patients (97 ¡¾ 67 mL versus 181 ¡¾ 74 mL, P < 0.05, t test).
Conclusion: Anorectal manometry is an objective method providing useful information that could guide a more adapted management in patients with defecation disorders after Hirschsprung¡¯s disease operation.
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KEYWORD
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Defecation, Follow-up studies, Hirschsprung disease, Manometry, Postoperative period
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