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Does anorectal manometry predict clinical outcome after laparoscopic ACE procedures in children with spina bifida?

N A Wing1, F J Findlay, S W Beasley

  • 1Department of Paediatric Surgery, Christchurch Hospital, Christchurch, New Zealand.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|June 7, 2003
PubMed

Insights

The laparoscopic antegrade continence enema (LACE) procedure effectively improves fecal incontinence in children with spina bifida. However, anorectal manometry results do not predict surgical outcomes for this condition.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Urology

Background:

  • Spina bifida frequently causes fecal incontinence.
  • The laparoscopic antegrade continence enema (LACE) procedure is a surgical option for managing fecal incontinence in children.
  • Assessing anorectal function is crucial for understanding treatment outcomes.

Purpose of the Study:

  • To evaluate the relationship between anorectal function, assessed by manometry, and the success of the LACE procedure in children with spina bifida.
  • To determine if pre-operative anorectal manometry can predict the functional continence achieved after LACE surgery.

Main Methods:

  • A cohort of eleven children with spina bifida who underwent the LACE procedure were studied.
  • Anorectal manometry (ARM) was performed to assess anorectal function in these patients.
  • The ARM parameters were correlated with the level of functional continence achieved post-surgery.

Main Results:

  • The LACE procedure resulted in a high level of functional continence across all patients.
  • Significant variability was observed in the anorectal manometry parameters among the children.
  • No statistically significant correlation was found between manometric findings and the surgical outcome.

Conclusions:

  • Anorectal manometry is not a reliable predictor of the outcome for the laparoscopic antegrade continence enema procedure in pediatric spina bifida patients.
  • The LACE procedure demonstrates consistent efficacy in improving continence, irrespective of baseline manometric measurements.
Abstract

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