Post-operative colonic manometry in children with anorectal malformations: A systematic review

Hannah M E Evans-Barns; Melissa Y Tien; Misel Trajanovska; Mark Safe; John M Hutson; Phil G Dinning; Sebastian K King

doi:10.1111/nmo.14415

Post-operative colonic manometry in children with anorectal malformations: A systematic review

Neurogastroenterol Motil. 2022 Dec;34(12):e14415. doi: 10.1111/nmo.14415. Epub 2022 Jun 14.

Authors

Hannah M E Evans-Barns^{1

2

3}, Melissa Y Tien³, Misel Trajanovska^{1

2

3}, Mark Safe⁴, John M Hutson^{2

3

5}, Phil G Dinning⁶, Sebastian K King^{1

2

3}

Affiliations

¹ Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Victoria, Australia.
² Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
³ Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
⁴ Department of Gastroenterology and Clinical Nutrition, The Royal Children's Hospital, Melbourne, Victoria, Australia.
⁵ Department of Urology, The Royal Children's Hospital, Melbourne, Victoria, Australia.
⁶ Department of Surgery, College of Medicine and Public Health, The Flinders University and Flinders Medical Centre, Bedford Park, South Australia, Australia.

Abstract

Background: Children with anorectal malformations may experience constipation and fecal incontinence following repair. The contribution of altered anorectal function to these persistent symptoms is relatively intuitive; however, colonic motility in this cohort is less well understood. Manometry may be used to directly assess colonic motility.

Purpose: The purpose of this systematic review was to synthesize the available evidence regarding post-operative colonic motility in children with anorectal malformations and evaluate the reported equipment and protocols used to perform colonic manometry in this cohort. This systematic review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We conducted a systematic review of four databases: Embase, MEDLINE, PubMed, and the Cochrane Library (1^st January 1985-22^nd July 2021). Studies reporting colonic manometry performed in children following anorectal malformation repair were assessed for eligibility. Data were extracted independently by two authors. Four studies were eligible for inclusion. Of the combined total cohort of 151 children, post-operative colonic manometry was conducted in 35. Insufficient reporting of medical characteristics, bowel function, and manometric outcomes restricted comparison between studies, and limited clinical applicability. No results from high-resolution colonic manometry were identified. Despite the prevalence of post-operative bowel dysfunction in children with repaired anorectal malformations, this systematic review highlighted the markedly limited evidence regarding post-operative colonic motility. This cohort may benefit from assessment with high-resolution techniques; however, future work must emphasize adherence to standardized manometry protocols, and include robust reporting of surgical characteristics, bowel function, and manometric outcomes.

Keywords: anorectal malformation; colon; gastrointestinal motility; manometry.

Publication types

Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Anal Canal / surgery
Anorectal Malformations*
Child
Colon
Constipation
Fecal Incontinence* / diagnosis
Humans
Manometry / methods
Rectum