Pathology of the enteral nervous system in children with anorectal malformations



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Abstract

Introduction. The review describes a pathology of the enteric nervous system (ENS) in patients with anorectal malformations (ARM). Functional gastrointestinal disorders in children with APM after anorectoplasty (bowel impaction, constipation and fecal incontinence) is an actual problem in pediatric surgery.
Materials. Literature searches was done in Scopus, PubMed, Google Scolar and eLibrary databases.
Results. Reasons of unsatisfactory outcomes after the treatment are various: underdevelopment of pelvic floor muscles, low sacral ratio, redo procedures. In recent years, a certain attention has been paid to the pathology of enteric nervous system in the structure of ARM pathologies, since the intrauterine migration of neuroblasts and formation of the intestinal neuronal network are inextricably linked with the hindgut anlage. At the same time, literature on ENS state in children with anorectal transformations is not numerous and scattered. Impairments in ENS development in patients with ARM, by different authors, ranges from 3.5 to 94%. By findings of multicenter trials, the incidence of true agangliosis (Hirschsprung’s disease) in children with ARM is low (up to 3.4%).
Conclusion. ARM is a group of congenital malformations of the anorectal region. The quality of life of such patients often worsens after surgery due to functional disorders, such as incomplete bowel movements, constipation and fecal incontinence. Further researches are needed to identify changes in ENS in patients with anorectal malformations in order to correct management tactics and improve their quality of life after surgery.

About the authors

E. S. Pimenova

Sechenov First Moscow State Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0001-7206-5987

Moscow, 119991

Russian Federation

G. A. Korolev

Sechenov First Moscow State Medical University

Author for correspondence.
Email: KorolevG.A@yandex.ru
ORCID iD: 0000-0001-5730-3684

Grigoriy А. Korolev, resident, department of pediatric surgery and urology-andrology 

Moscow, 119991

Russian Federation

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