Post-Operative Anorectal Manometry in Children following Anorectal Malformation Repair: A Systematic Review

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Urology

Background:

• Children with anorectal malformations (ARMs) often face long-term bowel dysfunction post-surgery.
• Anorectal manometry is crucial for assessing anorectal function in this cohort.
• Existing data on manometry in pediatric ARMs lacks comprehensive synthesis.

Purpose of the Study:

• To systematically review and evaluate anorectal manometry results in children after ARM repair.
• To assess the variability in manometry protocols, including equipment, assessment, and interpretation.

Main Methods:

• Systematic review of Embase, MEDLINE, Cochrane Library, and PubMed (1985-2022).
• Inclusion of studies reporting post-operative anorectal manometry in children (<18 years) with ARMs.
• Evaluation of 63 eligible studies involving 1755 patients.

Main Results:

• Reduced resting pressure was a consistent finding, particularly in complex ARMs and with fecal incontinence.
• Significant variability observed in manometry equipment, protocols, and interpretation methods.
• Limited reporting of patient characteristics impeded contextual interpretation of manometry findings.

Conclusions:

• A significant lack of standardization in anorectal manometry protocols exists for pediatric ARMs.
• This variability challenges the interpretation and comparison of manometry results.
• Standardized protocols and consistent analysis are vital for clinical relevance and comparability.