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Bowel function after surgery for anorectal malformations in patients with tethered spinal cord
Tethered spinal cord (TC) is an anomaly frequently recognized in association with anorectal malformations (ARM). However, the influence of TC on bowel function in children with ARM remains unknown. Furthermore, there are few studies that have assessed anorectal function in children with ARM and TC....
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| Published in: | Pediatric surgery international 2007-12, Vol.23 (12), p.1171-1174 |
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| creator | Tsuda, Tomoki Iwai, Naomi Kimura, Osamu Kubota, Yoshihiro Ono, Shigeru Sasaki, Yasunari |
| description | Tethered spinal cord (TC) is an anomaly frequently recognized in association with anorectal malformations (ARM). However, the influence of TC on bowel function in children with ARM remains unknown. Furthermore, there are few studies that have assessed anorectal function in children with ARM and TC. The aim of this study was to evaluate anorectal function in ARM patients with TC using clinical assessment and anorectal manometry. Among 258 patients with ARM, this retrospective investigation included 35 patients who underwent spinal magnetic resonance imaging (MRI) after surgery for ARM. The patients were divided into two groups based on the presence or absence of TC, and bowel function was assessed by Kelly's clinical score and anorectal manometry. Tethered cord was found in nine of the 35 patients (26%) with ARM. Of the ARM patients, TC was noted in four of 11 (36%) with high type anomalies, one of 8 (13%) with intermediate type anomalies, two of 14 (14%) with low type anomalies, and two of two patients (100%) with cloacal anomalies. Kelly's clinical score did not significantly differ between the two groups. However, two of the nine patients with TC had poor bowel function (Kelly's score; 2-0 points). On the contrary, patients without TC did not have poor bowel function. Anorectal manometry did not show a significant difference between patients with and without TC. However, the two patients with TC who had poor bowel function by Kelly's score had low anal resting pressure, which was essential for achieving fecal continence. In conclusion, the present study showed that tethered cord was more frequently found in patients with more severe anorectal anomalies. Patients with TC were more likely to have poor bowel function, but this did not reach statistical significance. |
| doi_str_mv | 10.1007/s00383-007-2025-4 |
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However, the influence of TC on bowel function in children with ARM remains unknown. Furthermore, there are few studies that have assessed anorectal function in children with ARM and TC. The aim of this study was to evaluate anorectal function in ARM patients with TC using clinical assessment and anorectal manometry. Among 258 patients with ARM, this retrospective investigation included 35 patients who underwent spinal magnetic resonance imaging (MRI) after surgery for ARM. The patients were divided into two groups based on the presence or absence of TC, and bowel function was assessed by Kelly's clinical score and anorectal manometry. Tethered cord was found in nine of the 35 patients (26%) with ARM. Of the ARM patients, TC was noted in four of 11 (36%) with high type anomalies, one of 8 (13%) with intermediate type anomalies, two of 14 (14%) with low type anomalies, and two of two patients (100%) with cloacal anomalies. Kelly's clinical score did not significantly differ between the two groups. However, two of the nine patients with TC had poor bowel function (Kelly's score; 2-0 points). On the contrary, patients without TC did not have poor bowel function. Anorectal manometry did not show a significant difference between patients with and without TC. However, the two patients with TC who had poor bowel function by Kelly's score had low anal resting pressure, which was essential for achieving fecal continence. In conclusion, the present study showed that tethered cord was more frequently found in patients with more severe anorectal anomalies. Patients with TC were more likely to have poor bowel function, but this did not reach statistical significance.</description><identifier>ISSN: 0179-0358</identifier><identifier>EISSN: 1437-9813</identifier><identifier>DOI: 10.1007/s00383-007-2025-4</identifier><identifier>PMID: 17924121</identifier><language>eng</language><publisher>Germany: Springer Nature B.V</publisher><subject>Abnormalities, Multiple ; Adolescent ; Adult ; Anal Canal - abnormalities ; Anal Canal - physiopathology ; Anus Diseases - congenital ; Anus Diseases - physiopathology ; Anus Diseases - surgery ; Child ; Child, Preschool ; Digestive System Surgical Procedures - methods ; Female ; Follow-Up Studies ; Gastrointestinal Motility - physiology ; Humans ; Magnetic Resonance Imaging ; Male ; Manometry ; Neural Tube Defects - diagnosis ; Neural Tube Defects - physiopathology ; Postoperative Period ; Pressure ; Prognosis ; Rectal Diseases - congenital ; Rectal Diseases - physiopathology ; Rectal Diseases - surgery ; Rectum - abnormalities ; Rectum - physiopathology ; Retrospective Studies</subject><ispartof>Pediatric surgery international, 2007-12, Vol.23 (12), p.1171-1174</ispartof><rights>Springer-Verlag 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c355t-7c51e0691ebf06d4f41a95b52b1536635c2947fb17d348facf38e1343053ac583</citedby><cites>FETCH-LOGICAL-c355t-7c51e0691ebf06d4f41a95b52b1536635c2947fb17d348facf38e1343053ac583</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17924121$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tsuda, Tomoki</creatorcontrib><creatorcontrib>Iwai, Naomi</creatorcontrib><creatorcontrib>Kimura, Osamu</creatorcontrib><creatorcontrib>Kubota, Yoshihiro</creatorcontrib><creatorcontrib>Ono, Shigeru</creatorcontrib><creatorcontrib>Sasaki, Yasunari</creatorcontrib><title>Bowel function after surgery for anorectal malformations in patients with tethered spinal cord</title><title>Pediatric surgery international</title><addtitle>Pediatr Surg Int</addtitle><description>Tethered spinal cord (TC) is an anomaly frequently recognized in association with anorectal malformations (ARM). However, the influence of TC on bowel function in children with ARM remains unknown. Furthermore, there are few studies that have assessed anorectal function in children with ARM and TC. The aim of this study was to evaluate anorectal function in ARM patients with TC using clinical assessment and anorectal manometry. Among 258 patients with ARM, this retrospective investigation included 35 patients who underwent spinal magnetic resonance imaging (MRI) after surgery for ARM. The patients were divided into two groups based on the presence or absence of TC, and bowel function was assessed by Kelly's clinical score and anorectal manometry. Tethered cord was found in nine of the 35 patients (26%) with ARM. Of the ARM patients, TC was noted in four of 11 (36%) with high type anomalies, one of 8 (13%) with intermediate type anomalies, two of 14 (14%) with low type anomalies, and two of two patients (100%) with cloacal anomalies. Kelly's clinical score did not significantly differ between the two groups. However, two of the nine patients with TC had poor bowel function (Kelly's score; 2-0 points). On the contrary, patients without TC did not have poor bowel function. Anorectal manometry did not show a significant difference between patients with and without TC. However, the two patients with TC who had poor bowel function by Kelly's score had low anal resting pressure, which was essential for achieving fecal continence. In conclusion, the present study showed that tethered cord was more frequently found in patients with more severe anorectal anomalies. Patients with TC were more likely to have poor bowel function, but this did not reach statistical significance.</description><subject>Abnormalities, Multiple</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Anal Canal - abnormalities</subject><subject>Anal Canal - physiopathology</subject><subject>Anus Diseases - congenital</subject><subject>Anus Diseases - physiopathology</subject><subject>Anus Diseases - surgery</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Digestive System Surgical Procedures - methods</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastrointestinal Motility - physiology</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Manometry</subject><subject>Neural Tube Defects - diagnosis</subject><subject>Neural Tube Defects - physiopathology</subject><subject>Postoperative Period</subject><subject>Pressure</subject><subject>Prognosis</subject><subject>Rectal Diseases - congenital</subject><subject>Rectal Diseases - physiopathology</subject><subject>Rectal Diseases - surgery</subject><subject>Rectum - abnormalities</subject><subject>Rectum - physiopathology</subject><subject>Retrospective Studies</subject><issn>0179-0358</issn><issn>1437-9813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><recordid>eNpdkEtr3DAUhUVJSCbT_IBsguiiOzf36uHHsg1pUwhkk2wjZPmqcbCtqSQT5t_XZgYKWd3D4TuHy2HsCuEbAlQ3CUDWslhkIUDoQn1iG1SyKpoa5QnbAFZNAVLX5-wipTcAqGXZnLHzxRcKBW7Yy4_wTgP38-RyHyZufabI0xz_UNxzHyK3U4jksh34aIfFGO0KJt5PfLdImnLi731-5ZnyK0XqeNr104K7ELvP7NTbIdHl8W7Z88-7p9v74uHx1-_b7w-Fk1rnonIaCcoGqfVQdsortI1utWhRy7KU2olGVb7FqpOq9tZ5WRNKJUFL63Qtt-zroXcXw9-ZUjZjnxwNg50ozMmUtUZooFnALx_AtzDH5d1khBAVAJZqgfAAuRhSiuTNLvajjXuDYNblzWF5s8p1ebNmro_FcztS9z9xnFr-A99IfqQ</recordid><startdate>20071201</startdate><enddate>20071201</enddate><creator>Tsuda, Tomoki</creator><creator>Iwai, Naomi</creator><creator>Kimura, Osamu</creator><creator>Kubota, Yoshihiro</creator><creator>Ono, Shigeru</creator><creator>Sasaki, Yasunari</creator><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20071201</creationdate><title>Bowel function after surgery for anorectal malformations in patients with tethered spinal cord</title><author>Tsuda, Tomoki ; Iwai, Naomi ; Kimura, Osamu ; Kubota, Yoshihiro ; Ono, Shigeru ; Sasaki, Yasunari</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c355t-7c51e0691ebf06d4f41a95b52b1536635c2947fb17d348facf38e1343053ac583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Abnormalities, Multiple</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Anal Canal - abnormalities</topic><topic>Anal Canal - physiopathology</topic><topic>Anus Diseases - congenital</topic><topic>Anus Diseases - physiopathology</topic><topic>Anus Diseases - surgery</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Digestive System Surgical Procedures - methods</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastrointestinal Motility - physiology</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Manometry</topic><topic>Neural Tube Defects - diagnosis</topic><topic>Neural Tube Defects - physiopathology</topic><topic>Postoperative Period</topic><topic>Pressure</topic><topic>Prognosis</topic><topic>Rectal Diseases - congenital</topic><topic>Rectal Diseases - physiopathology</topic><topic>Rectal Diseases - surgery</topic><topic>Rectum - abnormalities</topic><topic>Rectum - physiopathology</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tsuda, Tomoki</creatorcontrib><creatorcontrib>Iwai, Naomi</creatorcontrib><creatorcontrib>Kimura, Osamu</creatorcontrib><creatorcontrib>Kubota, Yoshihiro</creatorcontrib><creatorcontrib>Ono, Shigeru</creatorcontrib><creatorcontrib>Sasaki, Yasunari</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database (ProQuest)</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric surgery international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tsuda, Tomoki</au><au>Iwai, Naomi</au><au>Kimura, Osamu</au><au>Kubota, Yoshihiro</au><au>Ono, Shigeru</au><au>Sasaki, Yasunari</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bowel function after surgery for anorectal malformations in patients with tethered spinal cord</atitle><jtitle>Pediatric surgery international</jtitle><addtitle>Pediatr Surg Int</addtitle><date>2007-12-01</date><risdate>2007</risdate><volume>23</volume><issue>12</issue><spage>1171</spage><epage>1174</epage><pages>1171-1174</pages><issn>0179-0358</issn><eissn>1437-9813</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Tethered spinal cord (TC) is an anomaly frequently recognized in association with anorectal malformations (ARM). However, the influence of TC on bowel function in children with ARM remains unknown. Furthermore, there are few studies that have assessed anorectal function in children with ARM and TC. The aim of this study was to evaluate anorectal function in ARM patients with TC using clinical assessment and anorectal manometry. Among 258 patients with ARM, this retrospective investigation included 35 patients who underwent spinal magnetic resonance imaging (MRI) after surgery for ARM. The patients were divided into two groups based on the presence or absence of TC, and bowel function was assessed by Kelly's clinical score and anorectal manometry. Tethered cord was found in nine of the 35 patients (26%) with ARM. Of the ARM patients, TC was noted in four of 11 (36%) with high type anomalies, one of 8 (13%) with intermediate type anomalies, two of 14 (14%) with low type anomalies, and two of two patients (100%) with cloacal anomalies. Kelly's clinical score did not significantly differ between the two groups. However, two of the nine patients with TC had poor bowel function (Kelly's score; 2-0 points). On the contrary, patients without TC did not have poor bowel function. Anorectal manometry did not show a significant difference between patients with and without TC. However, the two patients with TC who had poor bowel function by Kelly's score had low anal resting pressure, which was essential for achieving fecal continence. In conclusion, the present study showed that tethered cord was more frequently found in patients with more severe anorectal anomalies. Patients with TC were more likely to have poor bowel function, but this did not reach statistical significance.</abstract><cop>Germany</cop><pub>Springer Nature B.V</pub><pmid>17924121</pmid><doi>10.1007/s00383-007-2025-4</doi><tpages>4</tpages></addata></record> |
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| subjects | Abnormalities, Multiple Adolescent Adult Anal Canal - abnormalities Anal Canal - physiopathology Anus Diseases - congenital Anus Diseases - physiopathology Anus Diseases - surgery Child Child, Preschool Digestive System Surgical Procedures - methods Female Follow-Up Studies Gastrointestinal Motility - physiology Humans Magnetic Resonance Imaging Male Manometry Neural Tube Defects - diagnosis Neural Tube Defects - physiopathology Postoperative Period Pressure Prognosis Rectal Diseases - congenital Rectal Diseases - physiopathology Rectal Diseases - surgery Rectum - abnormalities Rectum - physiopathology Retrospective Studies |
| title | Bowel function after surgery for anorectal malformations in patients with tethered spinal cord |
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