J Neurogastroenterol Motil  
Interest of Anorectal Manometry During Long-term Follow-up of Patients Operated on for Hirschsprung’s Disease
Viet Q Tran,1,2* Tania Mahler,3 Patrick Bontems,3 Dinh Q Truong,1 Annie Robert,4 Philippe Goyens,5 and Henri Steyaert2
1Department of Pediatric Surgery, City Children’s Hospital, Ho Chi Minh City, Vietnam; Departments of 2Pediatric Surgery and 3Gastroenterology, Hôpital Universitaire des Enfants Reine Fabiola - Université Libre de Bruxelles (ULB), Brussels, Belgium; 4Faculté de santé publique, Institut de Recherche Expérimentale et Clinique (IREC), Pôle de recherche EPID Epidémiologie et Biostatistique - Université catholique de Louvain (UCL), Brussels, Belgium; and 5Laboratory of Pediatrics, Université Libre de Bruxelles (ULB), Brussels, Belgium
Correspondence to: Viet Q Tran, MD
Department of Pediatric Surgery, Hôpital Universitaire des Enfants Reine Fabiola - Université Libre de Bruxelles (ULB), Avenue Jean-Joseph Crocq 15 1020 Brussels, Belgium
Tel: +84-909-490-527, E-mail: dr.tranquocviet@gmail.com
Received: February 15, 2017; Revised: May 25, 2017; Accepted: July 12, 2017; Published online: November 25, 2017.
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

cc This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Although many advances in the management of Hirschsprung’s disease have recently been achieved, postoperative outcomes of these patients remain difficult in a non-negligible number of cases. Therefore, this study aims at investigating characteristics of anorectal manometry and its relationship with postoperative outcomes during long-term follow-up in Hirschsprung patients.
Patients over 4 years of age operated on for Hirschsprung’s disease were interviewed to complete detailed questionnaires on bowel function. The patients who consented to undergo an anorectal manometry during follow-up were enrolled in this study. We investigated their clinical characteristics, manometric findings, and their postoperative bowel function.
Nineteen patients out of 53 patients (35.8%) were enrolled, 68.0% who were male. Mean age of patients at manometry was 11.3 ± 6.3 years. Twelve out of 19 patients (63.2%) were incontinent. The mean anal resting pressures of incontinent patients were significantly lower than continent patients (47 ± 12 mmHg versus 63 ± 11 mmHg, P 〈 0.05, t test). Due to neurological impairment, only 11 patients (58.0%) were able to perform a complete manometry. A dyssynergic defecation was found in 4 patients during strain tests. Maximum tolerated volume of the incontinent patients was significantly lower than that of the continent patients (97 ± 67 mL versus 181 ± 74 mL, P 〈 0.05, t test).
Anorectal manometry is an objective method providing useful information that could guide a more adapted management in patients with defecation disorders after Hirschsprung’s disease operation.
Keywords: Defecation; Follow-up studies; Hirschsprung disease; Manometry; Postoperative period

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