Document Detail


Resting anal pressure following hemorrhoidectomy and lateral sphincterotomy.
MedLine Citation:
PMID:  16228838     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The role of high anal pressure in the pathophysiology of hemorrhoids and anal fissures is debated. We compared resting anal pressures following left lateral sphincterotomy and hemorrhoidectomy in a prospective manometric study with emphasis on the recovery of the internal anal sphincter activity. METHODS: Included in the study were 38 patients with third-degree or fourth-degree symptomatic hemorrhoids who underwent hemorrhoidectomy, 50 patients with anal fissure who underwent sphincterotomy, and 12 healthy patients who served as controls. All patients with anal fissure or hemorrhoids underwent periodic manometric evaluation: 1 month before surgery and 1, 3, 6, and 12 months after surgery. The control group had three manometric evaluations 6 months apart. RESULTS: Baseline pressure measurement in the fissure group was significantly higher than in the hemorrhoid group, which was significantly higher than in the control group (138 +/- 28.4 mmHg vs. 108.4 +/- 23 mmHg vs. 73 +/- 5.9 mmHg, P < 0.0001). Twelve months after surgery, anal resting pressure remained significantly lower than the baseline measurements in both the fissure (110 +/- 18.2 vs. 138 +/- 28.4, P < 0.0001) and hemorrhoid groups (103.6 +/- 21.5 vs. 108 +/- 23, P < 0.0001), but both remained higher than the control group (103.6 +/- 21.5 mmHg vs. 73 +/- 5.9 mmHg, P < 0.0001). CONCLUSIONS: Resting pressure is elevated in hemorrhoid and anal fissure patients. After surgery the anal resting pressure is reduced but is still higher than in the control group. Further studies are required to investigate the protective effect of postsurgical reduction of anal resting pressure against recurrence.
Authors:
Dan Alper; Edward Ram; Gideon Y Stein; Zeev Dreznik
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  48     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-12-23     Completed Date:  2006-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2080-4     Citation Subset:  IM    
Affiliation:
Division of General Surgery, Rabin Medical Center and Tel-Aviv University Sackler School of Medicine, Tel Aviv, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anal Canal / physiopathology*,  surgery*
Case-Control Studies
Chronic Disease
Female
Fissure in Ano / physiopathology,  surgery*
Follow-Up Studies
Hemorrhoids / physiopathology,  surgery*
Humans
Male
Manometry
Middle Aged
Pressure
Prospective Studies
Rest / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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