3D high-definition manometry in evaluation of children after surgery for Hirschsprung's disease: A pilot study

Area of Science:

• Pediatric surgery
• Gastroenterology
• Medical imaging

Background:

• Hirschsprung's disease is a congenital condition affecting the large intestine's nerve supply.
• Restorative surgical procedures are common for Hirschsprung's disease.
• Postoperative assessment of anorectal function is crucial for evaluating surgical outcomes.

Purpose of the Study:

• To evaluate the utility of three-dimensional high-definition anorectal manometry (3D HRM) for assessing patients after restorative surgery for Hirschsprung's disease.
• To compare anorectal function between different surgical procedures for Hirschsprung's disease using 3D HRM.

Main Methods:

• Solid-state 3D HRM was employed to evaluate anorectal function in 14 children.
• Key parameters measured included anal canal length, resting and squeeze pressures, rectoanal inhibitory reflex, cough reflex, ano-anal reflex, and bear down maneuver.
• Patients were grouped based on the surgical procedure: Duhamel or TEPT.

Main Results:

• Higher mean pressure asymmetry was observed in the Duhamel group compared to the TEPT group (resting: 29.58% vs. 22.26%; squeeze: 26.1% vs. 14.01%).
• The presence of the rectoanal inhibitory reflex differed significantly between groups (TEPT: 87.5% vs. Duhamel: 33%).
• No significant differences were found in other manometric parameters between the surgical groups.

Conclusions:

• Anorectal 3D HRM is a valuable tool for evaluating patients following Hirschsprung's disease surgery.
• While pressure asymmetry and rectoanal inhibitory reflex showed differences, anal canal asymmetry occurred similarly after both Duhamel and TEPT procedures.