Document Detail

Anorectal manovolumetry in the decision making before surgery for slow transit constipation.
MedLine Citation:
PMID:  17676264     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Colectomy with ileorectal anastomosis for slow transit constipation (STC) is being challenged by other operations, such as segmental resections. The importance of preoperative anorectal physiology testing may therefore be increased. The aim of this study was to identify anorectal abnormalities in patients with STC, which may influence the surgical approach. METHODS: Fifty consecutive patients with STC (43 women; median age, 49 years) and 28 controls (23 women; median age, 50 years) were examined with anorectal manovolumetry. Anal pressures and rectal volumes were recorded, at stepwise rectal distension. RESULTS: Anal resting pressure was lower in patients (median, 54 cm H(2)O; range, 22-130) than in controls (median, 68 cm H(2)O; range, 35-100) (p<0.05). Squeeze pressure tended to be lower in patients (median, 147 cm H(2)O; range, 53-382) than in controls (median, 177 cm H(2)O; range, 65-423) (p=0.09). Rectal sensory thresholds did not differ significantly between patients and controls, although 10 patients had a threshold for filling above the 95(th) percentile of controls. Rectal compliance was increased in patients in the pressure interval 5-35 cm H(2)O (p<0.05-0.01). The threshold and amplitude of the recto-anal inhibitory reflex did not differ significantly, but the recovery of resting pressure after eliciting the reflex was lower in patients than in controls in the pressure interval 10-50 cm H(2)O (p<0.05-0.001). CONCLUSIONS: More than half of the patients with STC deviated in some parameter. An impaired internal sphincter function and increased rectal compliance were seen. One fifth of the patients had impaired rectal sensation.
E Lundin; W Graf; U Karlbom
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-08-03
Journal Detail:
Title:  Techniques in coloproctology     Volume:  11     ISSN:  1123-6337     ISO Abbreviation:  Tech Coloproctol     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-19     Completed Date:  2007-12-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9613614     Medline TA:  Tech Coloproctol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  259-65     Citation Subset:  IM    
Department of Surgical Sciences Section of Surgery, University Hospital, SE-751 85, Uppsala, Sweden.
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MeSH Terms
Anal Canal / physiopathology*,  radiography
Constipation / physiopathology*,  radiography,  surgery*
Contrast Media
Decision Making*
Gastrointestinal Transit / physiology*
Manometry / methods*
Middle Aged
Rectum / physiopathology*,  radiography
Severity of Illness Index
Statistics, Nonparametric
Reg. No./Substance:
0/Contrast Media

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