Document Detail


Endorectal Ultrasound and Real-Time Elastography in Patients with fecal Incontinence Following Anorectal Surgery: A Prospective Comparison Evaluating Short- and Long-Term Outcomes in Irradiated and Non-Irradiated Patients.
MedLine Citation:
PMID:  23225555     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background and Aims: Transanal real-time elastography (RTE) was demonstrated to yield valuable information regarding elastic properties of the anal sphincter in patients with fecal incontinence. We studied the role of RTE findings as a risk factor for the outcome of patients with fecal incontinence following anorectal surgery in irradiated and non-irradiated individuals and compared these observations with conventional B-mode/color Doppler EUS. Patients and Methods: 90 patients with postsurgical fecal incontinence were included in this prospective monocentric study. Baseline and follow-up (after 3 weeks and 1 year) assessment included an incontinence severity score questionnaire, rectal manometry, B-mode/color Doppler EUS and RTE with quantitation of the sphincter elastograms. Results: 81 patients could be finally assessed, in 24 patients (29.6 %) a pathological elastogram with predominantly hard elements was found; logistic regression analysis revealed no significant association with the short- and long-term clinical outcome nor were any differences seen between irradiated and non-irradiated patients. Defined sphincter defects as seen with conventional EUS were significanntly associated with a worse short- and long-term outcome: odds ratio ORshort-term: 1.414 (1.107 - 1.807, p = 0.0101); ORlong-term: 1.675 (95 % CI: 1.133 - 2.477; p = 0.0294). Submucosal thickening and hypervascularization were found more frequently in the irradiated group (p < 0.01).Conclusion: RTE with quantitation of sphincter elastic properties yields no further diagnostic and prognostic information compared to conventional EUS in irradiated and non-irradiated patients and, therefore, cannot be regarded as a new tool in the assessment of those patients. Our data further confirm the view that defined sphincter defects may be a major risk factor for an unfavorable outcome.
Authors:
H Allgayer; A Ignee; S Zipse; A Crispin; C F Dietrich
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-7
Journal Detail:
Title:  Zeitschrift fur Gastroenterologie     Volume:  50     ISSN:  1439-7803     ISO Abbreviation:  Z Gastroenterol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0033370     Medline TA:  Z Gastroenterol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1281-1286     Citation Subset:  -    
Copyright Information:
© Georg Thieme Verlag KG Stuttgart · New York.
Affiliation:
Department of Gastroenterology and Metabolism, Klinik Ob der Tauber, Bad Mergentheim, RehaZentren Baden Württemberg, Germany.
Vernacular Title:
Endorektaler Ultraschall (ERUS) und Real-Time-Elastografie (RTE) zur Evaluierung der analen Inkontinenz nach anorektalen Operationen.
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