Pathology of the enteral nervous system in children with anorectal malformations

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 fecalincontinence) 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, lowsacral ratio, redo procedures. In recent years, a certain attention has been paid to the pathology of enteric nervous systemin the structure of ARM pathologies, since the intrauterine migration of neuroblasts and formation of the intestinal neuronalnetwork are inextricably linked with the hindgut anlage. At the same time, literature on ENS state in children with anorectaltransformations 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 childrenwith 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 aftersurgery 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 theirquality of life after surgery.