Evidence map›Paper›PMID 40470484›Full record

ArticleGastro hep advances2025

Advancing Understanding of Anorectal Malformations Through Microfocus Computed Tomography Imaging of Resected Material.

Daniël Docter, Bernadette S de Bakker, Jaco Hagoort, Joris J T H Roelofs, Sjoerd de Beer, Ernst van Heurn, Joep Derikx, Marc A Benninga, Justin de Jong, Ramon R Gorter

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Article in Gastro hep advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. High-resolution 3D micro-CT reveals an additional muscle layer in esophageal atresia.Esophagus : official journal of the Japan Esophageal Society · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Daniël DocterDepartment of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.
Bernadette S de BakkerDepartment of Obstetrics and Gynecology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.
Jaco HagoortDepartment of Medical Biology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands.
Joris J T H RoelofsDepartment of Pathology, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands.
Sjoerd de BeerDepartment of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.
Ernst van HeurnDepartment of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.
Joep DerikxDepartment of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.
Marc A BenningaDepartment of Pediatrics, Amsterdam UMC Location AMC, Amsterdam, The Netherlands.
Justin de JongDepartment of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.
Ramon R GorterDepartment of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Aims: Patients born with anorectal malformations (ARMs) might experience constipation and fecal incontinence. During ARM surgery (anterior and posterior sagittal anorectoplasty procedure), the distal part of the bowel (fistula) is usually resected. Microfocus computed tomography (micro-CT) imaging, capable of imaging samples in ultra-high 3-dimensional resolution, can be used to learn from this resected material. Through this technique, we aim to investigate whether or not structures, such as the internal anal sphincter (IAS), are present within this fistula. Methods: Pediatric patients undergoing surgical reconstruction for ARM were eligible for inclusion. Resected fistulas were fixed using 4% paraformaldehyde and stained with 3.75% B-Lugol for 48 hours to improve soft tissue contrast. Scans were performed on a Phoenix Nanotom micro-CT with a voxel size between 4-6 μm. Samples were destained for subsequent histopathological examination. Outcomes were presence of structures like the IAS, epithelial transition zone and ganglia. ARM fistulas were compared with a fetal anal canal sample derived from the Dutch Fetal Biobank. Results: Eleven ARM fistulas were analyzed. All samples showed evidence of normal development of the rectal wall. Columnar epithelium and stratified squamous epithelium were observed. Muscle fibers were present, arranged in circular pattern that expanded toward the distal end, becoming the intrinsic sphincter (IAS). Ganglia were present with normal appearance. Conclusion: We present micro-CT imaging to research resected material to provide new insights in microscale anatomy. The fistula, currently resected during surgical reconstruction for ARM, contains vital structures like the IAS, normal epithelial transition zone and normal ganglion cells. Although clinical functionality should be studied in the future, our results indicate that the fistula has a normal anal canal morphology and should be spared during ARM reconstruction if possible.

Indexed as

HistologyLow Type Anorectal MalformationsMicrofocus Computed TomographyPediatric SurgerySimple Anorectal Malformations

Identifiers

PMID40470484
PMCPMC12136826

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.