Prognostic evaluation of biofeedback response in patients treated for anorectal malformation

Caruso, Anna; Catalano, Pieralba; Voti, Giuseppe Li; Salerno, Sergio; Casuccio, Alessandra; Pace, Maria Rita Di; Cimador, Marcello

doi:10.1016/j.jpedsurg.2015.03.068

Cited by 13 publications

(13 citation statements)

References 28 publications

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“…A range of sedation strategies were reported, including chloral hydrate, ketamine, and nitrous oxide [ 26 , 28 , 29 , 30 , 31 , 34 , 35 , 38 , 39 , 47 , 48 , 49 , 54 , 57 , 63 , 69 , 73 ]. Anorectal manometry was performed without sedation in nine studies [ 14 , 22 , 32 , 43 , 50 , 52 , 55 , 57 , 67 ]. Reported approaches to preparation and sedation are summarized in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

Post-Operative Anorectal Manometry in Children following Anorectal Malformation Repair: A Systematic Review

Evans-Barns

Tien

Trajanovska

et al. 2023

JCM

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Despite surgical correction, children with anorectal malformations may experience long-term bowel dysfunction, including fecal incontinence and/or disorders of evacuation. Anorectal manometry is the most widely used test of anorectal function. Although considerable attention has been devoted to its application in the anorectal malformation cohort, there have been few attempts to consolidate the findings obtained. This systematic review aimed to (1) synthesize and evaluate the existing data regarding anorectal manometry results in children following anorectal malformation repair, and (2) evaluate the manometry protocols utilized, including equipment, assessment approach, and interpretation. We reviewed four databases (Embase, MEDLINE, the Cochrane Library, and PubMed) for relevant articles published between 1 January 1985 and 10 March 2022. Studies reporting post-operative anorectal manometry in children (<18 years) following anorectal malformation repair were evaluated for eligibility. Sixty-three studies were eligible for inclusion. Of the combined total cohort of 2155 patients, anorectal manometry results were reported for 1755 children following repair of anorectal malformations. Reduced resting pressure was consistently identified in children with anorectal malformations, particularly in those with more complex malformation types and/or fecal incontinence. Significant variability was identified in relation to manometry equipment, protocols, and interpretation. Few studies provided adequate cohort medical characteristics to facilitate interpretation of anorectal manometry findings within the context of the broader continence mechanism. This review highlights a widespread lack of standardization in the anorectal manometry procedure used to assess anorectal function in children following anorectal malformation repair. Consequently, interpretation and comparison of findings, both within and between institutions, is exceedingly challenging, if not impossible. Standardized manometry protocols, accompanied by a consistent approach to analysis, including definitions of normality and abnormality, are essential to enhance the comparability and clinical relevance of results.

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Section: Resultsmentioning

confidence: 99%

Post-Operative Anorectal Manometry in Children following Anorectal Malformation Repair: A Systematic Review

Evans-Barns

Tien

Trajanovska

et al. 2023

JCM

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“…Anorectal manometry is a test that measures the neuromuscular function of the rectum and anal sphincter complex ( 31 – 33 ). The latest internationally recognized examination procedure is high-resolution anorectal manometry (HR-ARM).…”

Section: Diagnosis Of Fi In Children and Adolescentsmentioning

confidence: 99%

“…They found the overall response to biofeedback to be excellent in 44%, discrete in 40%, and poor in 16%. The manometry can evaluate the potential sphincter recovery after biofeedback ( 33 ). FI in children can also result from pelvic floor dysfunction or dyssynergic defecation, which can be both myogenic and neurogenic.…”

Section: Management Of Fi In Children and Adolescentsmentioning

confidence: 99%

Diagnosis and management of fecal incontinence in children and adolescents

Shen

Zhang²,

Bai

et al. 2022

Front. Pediatr.

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Fecal incontinence (FI) is a commonly occurring disease of high concern. It is characterized by voluntary and involuntary defecation in children and adolescents. It is not only a physical disease but also a psychological and behavioral disorder. FI poses a serious burden on individuals and their families and therefore has become a social problem. Unfortunately, the management of FI among children is still a challenge because the etiology varies widely. Constipation has been found to be the most common cause, while sphincter dysfunction and neurogenic abnormalities may also play a role. Currently, no consensus guidelines exist, and the criteria for selecting optional methods remain unclear. It is therefore necessary to improve the efficacy of diagnosis and management strategies of FI in children. This review focused on the classification and etiology, discussed the diagnosis and management methods of FI in children and adolescents, and aimed to guide future studies.

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“…Anorectal malformation is a complex congenital anomaly that require an individualized treatment strategy which include preoperative evaluation, operative reconstruction, and postoperative care [15]. Biofeedback converted physiologic process is into simple visual or auditory signal to control abnormal function [16] and improved soiling frequency, Rintala continence score; pelvic muscle electromyography and anal sphincter function [17], achieved good contractile functioning of the sphincteric muscular complex [18,19] and enhanced sphincter recovery after ARM repair [20]. Biofeedback is recommended for fecal incontinence caused by the dysfunction of the anal sphincter and functional incontinence [21].…”

Section: Introductionmentioning

confidence: 99%

Biofeedback on Faecal Incontinence After Anorectal Malformations Repair: Effects Through Four Months: A Randomized Controlled Trial

Elshafey

Serag

Abdrabo

2020

Fiz Pol

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Background. Surgical repair for anorectal malformation in children had post-operative unsatisfactory results as children still suffering from faecal incontinence. Objective. The effect of Biofeedback in treating children fecal incontinence after anorectal malformations repair was investigated. Methodology. A randomized controlled trial design was conducted in the Pediatric hospital, Mansoura University. Forty-eight children with postsurgical anorectal malformations repair were assessed for eligibility. Forty children (twenty-two boys and eighteen girls) underwent simple randomization into two matched groups, control and study group. The anal function was assessed by Anorectal manometry and faecal incontinence was evaluated by Baylor social continence scale. Measurements were done before and after two months of intervention, and after four months of follow-up. Result. There was statistically significant improvement in maximal resting anal pressure, maximal voluntary contraction pressure, voluntary contraction time, the threshold of rectal sensation, maximal tolerable rectal volume and Baylor social continence scale (P < 0.05) for biofeedback group after two months of intervention and four months of follow-up in comparison with conservative treatment. Conclusion. Biofeedback improved faecal incontinence after ARM repair and had an intermediate follow up effect in conjunction with conservative interventions.

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Prognostic evaluation of biofeedback response in patients treated for anorectal malformation

Cited by 13 publications

References 28 publications

Post-Operative Anorectal Manometry in Children following Anorectal Malformation Repair: A Systematic Review

Post-Operative Anorectal Manometry in Children following Anorectal Malformation Repair: A Systematic Review

Diagnosis and management of fecal incontinence in children and adolescents

Biofeedback on Faecal Incontinence After Anorectal Malformations Repair: Effects Through Four Months: A Randomized Controlled Trial

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