| Anorectal manovolumetry in the decision making before surgery for slow transit constipation. | |
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MedLine Citation:
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PMID: 17676264 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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E Lundin; W Graf; U Karlbom |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-08-03 |
Journal Detail:
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Title: Techniques in coloproctology Volume: 11 ISSN: 1123-6337 ISO Abbreviation: Tech Coloproctol Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-09-19 Completed Date: 2007-12-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9613614 Medline TA: Tech Coloproctol Country: Italy |
Other Details:
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Languages: eng Pagination: 259-65 Citation Subset: IM |
Affiliation:
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Department of Surgical Sciences Section of Surgery, University Hospital, SE-751 85, Uppsala, Sweden. erik.lundin@surgsci.uu.se |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anal Canal
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physiopathology*,
radiography Constipation / physiopathology*, radiography, surgery* Contrast Media Decision Making* Female Gastrointestinal Transit / physiology* Humans Male Manometry / methods* Middle Aged Questionnaires Rectum / physiopathology*, radiography Severity of Illness Index Statistics, Nonparametric |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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