Anorectal Atresia, Anorectal Disorder, Children, Hirschsprung Disease
Conditions
Keywords
high resolution manometry, children, congenital anorectal disorder, surgery
Brief summary
3D high resolution anorectal manometry (3DHRAM) is the most precise tool to assess function and 3D topographic picture of pressures along the anal canal. Until now, it has been used only in adult population to evaluate defecatory disorders. Congenital anorectal disorders are severe conditions and may present wide spectrum of symptoms from gastrointestinal tract. The usefulness of the 3DHRAM hasn't been evaluated in children after surgery for anorectal disorders such as Hirschsprung's disease and anorectal malformations. It may help for better understanding of pathophysiology of anorectal area and allow for planning improved procedures in these patients. Moreover, the investigators study may elucidate the real usefulness of the procedure in management of disorders of gastrointestinal tract in pediatric population.
Interventions
Procedure will take about 15 minutes. During procedure resting, squeeze, bear down maneuver, cough, ano-anal and rectoanal inhibitory reflex will be obtained, if possible. 3D picture of pressures of anorectal will be recorded.
Sponsors
Medtronic - MITG
Medical University of Warsaw
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
12 Months to 18 Years
Healthy volunteers
No
Inclusion criteria
* age:1-18 yr * after surgery for Hirschsprung's disease, * after surgery for Anorectal malformations, * after total procto/colectomy * with parental agreement for the procedure
Exclusion criteria
* parental disagreement * children \<12 months of age and \>18 years
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean and maximum sphincters pressures during rest, voluntary squeeze and bear down maneuvers and asymmetry of the anal canal | 20 minutes | pressures will be recorded in mmHg |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Presence of sphincteric lesion in 3D picture of anal canal | 30 seconds | — |
| Presence of ano-anal reflex | 10 seconds | an increase in pressure during small movement of catheter inside and outside of the anal canal will be recorded by the sensors |
| Presence of rectoanal inhibitory reflex | 5 minutes | Amount of air inside the balloon needed to elicit rectoanal inhibitory reflex |
| Presence of discomfort during procedure | 20 minutes | — |
| Presence of dyssynergic defecation | 2 minutes | during bear down maneuver lasting 20 second and repeated 2 times with the resting period of 1 minute the configuration of pressures inside the rectum and anal canal will be recorded and analyzed according to the criteria of dyssynergic defecation |
| Presence of cough reflex | 10 seconds | an increase in pressure during cough will be recorded by the sensors |
Countries
Poland
Outcome results
None listed