Role of Anal Mucosal Electric Sensation in Postoperative Patients with Anorectal Malformation

Taro Ikeda, Ryouichi Tomita and Masahiro Fukuzawa

First Department of Surgery, Nihon University School of Medicine

Introduction: No previous reports have, to our knowledge, been made on anal mucosal electric sensation (AMES) in postoperative patients with anorectal malformation. We studied AEMS in comparison with clinical manifestation. Subjects: Subjects were 24 patients with anorectal malformation (ARM group) who underwent anorectoplasty (19 males and 5 females aged 5-48 years; mean age: 18.3 years) and 11 in a control group (4 males and 7 females aged 9-52 years; mean age: 30.7 years). Based on the type of anorectal malformation, patients were divided into 3 groups: high, 13; intermediate, 6; low, 5. Methods: AMES was measured at 3 positions, at the anal skin margin and 1 cm and 2 cm from the anal skin margin. AEMS was analyzed compared to the type of anorectal malformation and clinical manifestation. Results: AMES clearly increased at the 3 sites in ARM, especially high and intermediate, compared to the control group. The sensitivity threshold in the lower anal canal in low types was about the same as in the control group. An analysis of clinical manifestations showed significantly increased thresholds in the upper and middle anal canal in the group of patients with difficulty in distinguishing between gas and defecation, and with fecal incontinence (p<0.01 and p<0.05). Discussion: AMES for high and intermediate types in the ARM group was worse than that in the low types and normal groups. Anal canal mucosal electric sensitivity in the upper and middle anal canal was important for gas and defecation distinction and fecal maintenance.

Key words
anorectal malformations, anal sensation, anal mucosal electric sensitivity

Reprint requests
Taro Ikeda First Department of Surgery, Nihon University School of Medicine 30-1 Ohyaguchikamimachi, Itabashi-ku, Tokyo, 173-0032 JAPAN

Accepted
February 26, 2003

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