Evaluation of postoperative anal functions using endoanal ultrasonography and anorectal manometry in children with congenital anorectal malformations

Purpose: The aim of this study was to assess the postoperative anorectal anatomy and function in children with congenital anorectal malformations (ARM) using endoanal ultrasonography (EUS) and anorectal manometry. Methods: This study included 47 children who had undergone posterior sagittal anorectoplasty (PSARP) or transperineal anorectoplasty for the repair of an ARM. Children were grouped according to symptoms of defecation disorder, including normal defecation, fecal soiling, fecal incontinence, and constipation. Ten children with no history of anal or rectal diseases served as healthy controls. A well-established scoring system was used for the evaluation of anal function and defecation disorder. Results: EUS showed significant differences in the thickness of the interior sphincter between the ARM patients and the healthy controls (P < 0.05). However, no significant difference was found in the thickness of the interior sphincters between the PSARP group and transperineal anorectoplasty group (P > 0.05). Anorectal manometry showed that the balloon volumes were significantly different between the surgical group and the control group (P < 0.01), and between the low defect group and the intermediate-high defect group (P - 0.022). Balloon volume was significantly correlated with anal function scores (r = -0.30, P < 0.05). Conclusions: EUS and anorectal manometry can provide objective assessment of postoperative anorectal anatomy and function in children with ARM. (C) 2016 Elsevier Inc. All rights reserved.