We have located links that may give you full text access.
Clinical benefit of high resolution anorectal manometry for the evaluation of anal function after intersphincteric resection.
Colorectal Disease 2018 December 9
AIM: Intersphincteric resection (ISR) is an advanced anus-preserving operation for treating low rectal cancer while avoiding colostomy. High-resolution anorectal manometry (HR-ARM) allows objective and accurate evaluation of anal function. However, correlations between anal function after ISR and HR-ARM parameters are unknown. The aim of the study was to evaluate HR-ARM for objective evaluation of anal function after ISR.
METHOD: A total of 81 cases that underwent ISR at our hospital between October 2014 and March 2016 were identified from our our prospectively collected database and electronic medical records. Of these, 68 patients who had been evaluatedusing HR-ARM both before and after ISR were included in the study. Fecal incontinence (FI) was assessed by Wexner score. Multivariate analysis was performed to determine risk factors for severe FI after ISR.
RESULTS: Maximum resting pressure (MRP) (P<0.001) and maximum squeeze pressure (MSP) (P=0.04) were significantly lower after ISR, and MRP (P<0.001) and MSP (P=0.02) were significantly lower after total (or subtotal) ISR than after partial ISR. The overall incidence of severe FI after ISR was 18% (12/68), and a high pressure zone (HPZ) before ISR ≤3 cm (P=0.007) and MRP before ISR >60 mmHg (P=0.02) were independently associated with an elevated incidence of severe FI after ISR. Decreased preoperative MRP also correlated with severe FI after ISR (P=0.008).
CONCLUSION: HR-ARM is reliable for the evaluation of anal function after ISR, and HPZ and MRP may be useful preoperative predictors of severe FI after ISR. This article is protected by copyright. All rights reserved.
METHOD: A total of 81 cases that underwent ISR at our hospital between October 2014 and March 2016 were identified from our our prospectively collected database and electronic medical records. Of these, 68 patients who had been evaluatedusing HR-ARM both before and after ISR were included in the study. Fecal incontinence (FI) was assessed by Wexner score. Multivariate analysis was performed to determine risk factors for severe FI after ISR.
RESULTS: Maximum resting pressure (MRP) (P<0.001) and maximum squeeze pressure (MSP) (P=0.04) were significantly lower after ISR, and MRP (P<0.001) and MSP (P=0.02) were significantly lower after total (or subtotal) ISR than after partial ISR. The overall incidence of severe FI after ISR was 18% (12/68), and a high pressure zone (HPZ) before ISR ≤3 cm (P=0.007) and MRP before ISR >60 mmHg (P=0.02) were independently associated with an elevated incidence of severe FI after ISR. Decreased preoperative MRP also correlated with severe FI after ISR (P=0.008).
CONCLUSION: HR-ARM is reliable for the evaluation of anal function after ISR, and HPZ and MRP may be useful preoperative predictors of severe FI after ISR. This article is protected by copyright. All rights reserved.
Full text links
Related Resources
Trending Papers
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app