Correlation between development of terminal rectal ganglion and spinal cord/sacral abnormalities in boys with complex anorectal malformations
10.16016/j.2097-0927.202311063
- VernacularTitle:男性复杂肛门直肠畸形直肠末端神经节发育与脊髓/骶骨异常的相关性研究
- Author:
Minming CHEN
1
;
Jinping HOU
;
Wei FENG
;
Xiaohong DIE
;
Chenzhu XIANG
;
Yi WANG
Author Information
1. 400015 重庆,重庆医科大学附属儿童医院普外新生儿外科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿科学重庆市重点实验室
- Keywords:
anorectal malformations;
terminal rectal ganglion cells;
spinal cord anomalies;
sacral anomalies
- From:
Journal of Army Medical University
2024;46(3):265-270
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between the development of terminal rectal ganglion and spinal cord/sacral abnormalities in boys with complex anorectal malformations(ARMs)in order to improve the understanding of rectal ganglion development abnormalities in ARMs patients.Methods A retrospective trial was conducted on the male patients with complex ARMs admitted to our hospital from 2015 to 2021.The terminal rectal specimens were taken from them during anoplasty.According to the findings on development of terminal rectal ganglion after HE staining,the patients were classified into G1 group(ganglion cells observed)and G2 group(no ganglion cells observed).Imaging techniques were used to evaluate whether there were abnormalities in the spinal cord and sacrum,and their correlation with the terminal rectal ganglion development was analyzed.Results A total of 139 patients were enrolled,and their median age at anoplasty was 5.77(4.57,6.97)months.There were no significant differences between the G1(n=80,57.6%)and G2(n=59,42.4%)groups in ARMs pathological type(P=0.706)and age at surgery(P=0.140).Radiological findings showed there were 48 cases(34.5%)of spinal cord anomalies(SCA),25 cases(18.0%)of sacral abnormalities and 18 cases(12.9%)of coccyx abnormalities.No significant differences were observed in the incidences of SCA and sacral abnormalities between the G1 and G2 groups(P<0.05).Moreover,the differences of fatty filum terminale and syrinx were statistically significant(P<0.05).In addition,the ratio of sacrum to coccyx between the G1 and G2 groups were 0.72±0.10 vs 0.67±0.12(P<0.05)of the anteroposterior position and 0.77±0.09 vs 0.72±0.09(P<0.05)of the lateral position.Multivariate logistic regression analysis showed that sacral abnormalities,fatty filum terminale and syrinx were independent predictors of rectal terminal ganglion absence in male patients with complex ARMs.Conclusion The development of terminal rectal ganglia in male patients with ARMs is closely associated with the abnormalities of spinal cord and sacrum.Sacral abnormalities,fatty filum terminale and syrinx are independent predictors of rectal terminal ganglion absence in male patients with complex ARMs.