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Internal sphincter-saving in imperforate anus with or without fistula. A manometric study

F Penninckx, R Kerremans

    International Journal of Colorectal Disease
    |January 1, 1986
    PubMed

    Insights

    Preserving the internal sphincter during surgery for congenital anorectal anomalies is crucial. This study shows that maintaining sphincter function leads to normal manometric findings and good outcomes in infants.

    Area of Science:

    • Pediatric Surgery
    • Gastroenterology
    • Anorectal Malformations

    Background:

    • Congenital anorectal anomalies present diverse challenges in surgical correction.
    • The functional integrity of the internal sphincter is critical for continence.
    • Previous surgical approaches may have compromised sphincter preservation.

    Purpose of the Study:

    • To evaluate the manometric function of the internal sphincter in infants with congenital anorectal anomalies.
    • To assess the impact of surgical correction, specifically sphincter preservation and transplantation, on anorectal function.
    • To emphasize the importance of preserving the internal sphincter for optimal surgical outcomes.

    Main Methods:

    • Manometric assessment in 54 infants with various types of congenital anorectal anomalies.
    • Preoperative and/or postoperative evaluation based on the orifice's accessibility.
    • Surgical technique involved preserving and transplanting the ectopic rectal opening with its smooth musculature.

    Main Results:

    • All infants demonstrated a normally functioning internal sphincter post-transplantation.
    • Normal anal resting tone (32-51 mmHg) and anal slow pressure wave activity (11.6-15.7/min) were observed.
    • The recto-anal inhibitory reflex was consistently present in all cases.

    Conclusions:

    • Preservation and appropriate transplantation of the internal sphincter are vital for successful surgical correction of anorectal anomalies.
    • Manometric assessment confirms the functional integrity of the preserved sphincter.
    • Understanding and maintaining the internal sphincter's role can prevent poor functional results after surgery.

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