| Objective: Analyze the data of high resolution anorectal manometry(HRAM)in children with anorectal malformations(ARMs)in our hospital,summarize the relevant characteristics,and evaluate the basis for assessment of postoperative defecation function in children with ARMs.Methods: A total of 77 children with ARMs from 2014 to 2017 were selected and grouped according to rectal blind position and Kelly score.Follow-up of the defecation function and anorectal manometry from six month to 1 year after the final operation.Results:(1)The sample of 77 cases can be divided intow groups,32 lower groupand 45 Mid-high group,also can be dividedin two groups by Kelly-score,72 good function group and 5 poor function group.(2)The average resting pressure(38.00±12.33 mmHg,32.27±11.86 mmHg),maximum resting pressure(42.65±14.23 mmHg,36.67±12.10 mmHg),and effective length of the anal canal(2.43±0.30 cm,2.18±0.33cm)were significantly different between the lower-group and mid-high group of the good function group.The recovery rates of the rectal anal inhibitory reflexwere 90.63% and 17.50%,respectively,and the difference was statistically significant;(3)In the mid-high group,the average resting pressure(32.27±11.86 mmHg,26.08±2.36 mmHg)and the maximum resting pressure(36.67±12.10 mmHg,29.96±2.55 mmHg)were lower in the good function group than in the poor function group.There was a statistically significant difference between the two groups.(4)Through three-dimensional image analysis,the poor function group had a low pressure band or a pressure loss zone in the three-dimensional image.Conclusion:The transverse-loop colostomy can be used in the phased treatment of children with congenital anorectal malformations.The operation is simple and has few complications.It has no serious adverse effects on nutritional status and growth and development of children.It is a feasible and valusble colostomy method. |
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