LAUSR

OBJECTIVE Three-dimensional high-resolution anorectal manometry (3DHRAM) is the most precise tool for assessing the function of the anal canal. Our aim was to evaluate children after surgery for anorectal disorders using 3DHRAM. PATIENTS AND METHODS We prospectively enrolled 43 children (30 males; mean age: 7 years) after surgery for Hirschsprung's disease, anal atresia, or after proctocolectomy. Manometric data were compared to raw data obtained from previously studied children without symptoms arising from the lower gastrointestinal tract. Correlations between manometry and symptoms were evaluated. RESULTS The lowest values of the resting pressure, squeeze pressure, and pressure of the puborectalis muscle were observed in the anal atresia group (55.6 mmHg, 121.7 mmHg, and 44.17 mmHg, respectively). Compared to asymptomatic children, the lowest mean resting pressures were observed in those with non-retentive fecal incontinence (61.3 mmHg, p<0.000). The receiver operating curve cut-off value for the mean resting pressure between asymptomatic children and incontinent patients was 68.5 mmHg. The thresholds of urge were significantly higher in constipated patients compared to asymptomatic patients (87.5 cm³ and 30 cm³, respectively; p=0.003). CONCLUSIONS 3DHRAM may be a useful tool for assessing the function of the anorectum of children after surgery (NCT02296008).