Pediatric Gastroenterology, Hepatology & Nutrition

  • 제23권2호
  • /
  • Pages.137-145
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  • 2020
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  • 2234-8646(pISSN)
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  • 2234-8840(eISSN)
대한소아소화기영양학회 (The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition)
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Does the Oral-Anal Transit Test Correlate with Colonic Manometry Findings in Children with Refractory Constipation?

  • Dranove, Jason (Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Atrium Health Levine Children's Hospital) ;
  • Fleishman, Nathan (Department of Pediatric Gastroenterology, Children's Mercy Hospital) ;
  • Reddy, Saigopala (Department of Public Health, UNC Gillings School of Global Public Health) ;
  • Teich, Steven (Division of Pediatric Surgery, Atrium Health Levine Children's Hospital)
  • 투고 : 2019.09.22
  • 심사 : 2019.12.05
  • 발행 : 2020.03.15
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초록

Purpose: The Oral-anal Transit Test (OTT) is a simple method of obtaining information about colonic transit. We aim to assess the correlation of OTT with the neuromuscular integrity of the colon determined by colonic manometry (CM). Methods: All patients who had OTT followed by CM were evaluated. Less than 6 of 24 markers remaining on OTT was considered normal. CM was performed per previously published guidelines. A normal CM was defined as at least one High Amplitude Propagating Contraction progressing from the most proximal sensor through the sigmoid colon. Results: A total of 34 patients underwent both OTT and CM (44% male, age 4-18 years, mean 11.5 years, 97% functional constipation +/- soiling, Hirschsprung's Disease). Of normal and abnormal OTT patients, 85.7% (6/7) and 18.5% (5/27) respectively had normal CM. When all markers progressed to at least the sigmoid colon, this was 100% predictive against colonic inertia. Greater than 50% of patients with manometric isolated sigmoid dysfunction had markers proximal to the recto-sigmoid. Conclusion: OTT and CM are both valuable studies that assess different aspects of colonic function. OTT can be used as a screening test to rule out colonic inertia. However, the most proximal extent of remaining markers does not predict the anatomical extent of the manometric abnormality, particularly in isolated sigmoid dysfunction.

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참고문헌

  1. Wood RJ, Yacob D, Levitt MA. Surgical options for the management of severe functional constipation in children. Curr Opin Pediatr 2016;28:370-9. https://doi.org/10.1097/MOP.0000000000000345
  2. Tabbers MM, DiLorenzo C, Berger MY, Faure C, Langendam MW, Nurko S, et al.European Society for Pediatric Gastroenterology, Hepatology, and NutritionNorth American Society for Pediatric Gastroenterology. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr 2014;58:258-74. https://doi.org/10.1097/MPG.0000000000000266
  3. Koppen IJ, Di Lorenzo C, Saps M, Dinning PG, Yacob D, Levitt MA, et al. Childhood constipation: finally something is moving! Expert Rev Gastroenterol Hepatol 2016;10:141-55. https://doi.org/10.1586/17474124.2016.1098533
  4. Rodriguez L, Sood M, Di Lorenzo C, Saps M. An ANMS-NASPGHAN consensus document on anorectal and colonic manometry in children. Neurogastroenterol Motil 2017;29.
  5. Rao SS, Camilleri M, Hasler WL, Maurer AH, Parkman HP, Saad R, et al. Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies. Neurogastroenterol Motil 2011;23:8-23. https://doi.org/10.1111/j.1365-2982.2010.01612.x
  6. Koppen IJ, Kuizenga-Wessel S, Lu PL, Benninga MA, Di Lorenzo C, Lane VA, et al. Surgical decision-making in the management of children with intractable functional constipation: what are we doing and are we doing it right? J Pediatr Surg 2016;51:1607-12. https://doi.org/10.1016/j.jpedsurg.2016.05.023
  7. Gasior A, Reck C, Vilanova-Sanchez A, Diefenbach KA, Yacob D, Lu P, et al. Surgical management of functional constipation: an intermediate report of a new approach using a laparoscopic sigmoid resection combined with malone appendicostomy. J Pediatr Surg 2018;53:1160-2. https://doi.org/10.1016/j.jpedsurg.2018.02.074
  8. Tipnis NA, El-Chammas KI, Rudolph CD, Werlin SL, Sood MR. Do oro-anal transit markers predict which children would benefit from colonic manometry studies? J Pediatr Gastroenterol Nutr 2012;54:258-62. https://doi.org/10.1097/mpg.0b013e31822bbcd8
  9. Bharucha AE. High amplitude propagated contractions. Neurogastroenterol Motil 2012;24:977-82. https://doi.org/10.1111/nmo.12019
  10. Siddiqui AA, Fishman SJ, Bauer SB, Nurko S. Long-term follow-up of patients after antegrade continence enema procedure. J Pediatr Gastroenterol Nutr 2011;52:574-80. https://doi.org/10.1097/MPG.0b013e3181ff6042
  11. Siminas S, Losty PD. Current surgical management of pediatric idiopathic constipation: a systematic review of published studies. Ann Surg 2015;262:925-33. https://doi.org/10.1097/sla.0000000000001191
  12. Sood MR, Mousa H, Tipnis N, Di Lorenzo C, Werlin S, Fernandez S, et al. Interobserver variability in the interpretation of colon manometry studies in children. J Pediatr Gastroenterol Nutr 2012;55:548-51. https://doi.org/10.1097/mpg.0b013e3182569c8b
  13. Kuizenga-Wessel S, Mousa HM, Benninga MA, Di Lorenzo C. Lack of agreement on how to use antegrade enemas in children. J Pediatr Gastroenterol Nutr 2016;62:71-9. https://doi.org/10.1097/MPG.0000000000000899
  14. Abrahamsson H, Antov S, Bosaeus I. Gastrointestinal and colonic segmental transit time evaluated by a single abdominal x-ray in healthy subjects and constipated patients. Scand J Gastroenterol Suppl 1988;152 152 sup152:72-80. https://doi.org/10.3109/00365528809095938
  15. Chaussade S, Khyari A, Roche H, Garret M, Gaudric M, Couturier D, et al. Determination of total and segmental colonic transit time in constipated patients. Results in 91 patients with a new simplified method. Dig Dis Sci 1989;34:1168-72. https://doi.org/10.1007/BF01537263
  16. Giorgio V, Borrelli O, Smith VV, Rampling D, Koglmeier J, Shah N, et al. High-resolution colonic manometry accurately predicts colonic neuromuscular pathological phenotype in pediatric slow transit constipation. Neurogastroenterol Motil 2013;25:70-8.e8-9. https://doi.org/10.1111/nmo.12016
  17. King SK, Catto-Smith AG, Stanton MP, Sutcliffe JR, Simpson D, Cook I, et al. 24-Hour colonic manometry in pediatric slow transit constipation shows significant reductions in antegrade propagation. Am J Gastroenterol 2008;103:2083-91. https://doi.org/10.1111/j.1572-0241.2008.01921.x
  18. Ammoury RF, Emhardt JD, Aitchison WB, Horn DS, Croffie JM. Can colonic manometry studies be done on the day of colonic motility catheter placement? J Pediatr Gastroenterol Nutr 2012;55:278-82. https://doi.org/10.1097/mpg.0b013e31824ac64c