Document Detail


A new method of assessing anal sphincter integrity using inverted vectormanometry.
MedLine Citation:
PMID:  16708160     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Vectorgraphy as an integrated mapping of radial pressure profiles of the anal canal has been used to attempt identification of pressure-related defects with doubtful reliability since vectorgraphs bear no resemblance to endoanal ultrasound scans at similar levels in the anal canal. This study aimed to devise a technique to enable vectorgraphy to be more representative of sphincter function and integrity. METHODS: Vectormanometry was performed in 50 patients with anorectal disorders using an Arndorfer pneumohydraulic system. "Normal" three-dimensional manometric images of each 0.5 cm of the anal sphincter were computer-generated by plotting anal pressures at rest and during squeeze radially around a central zero axis. The graphs were replotted with zero at the periphery and maximal anal pressure at the center. Both this ("inverted") and "normal" vectorgraphs were compared with endoanal ultrasound images at similar levels, assessing both internal and external anal sphincters. RESULTS: Standard vectormanometry produced excellent pictures of pressures throughout the anal canal; the anatomy however bore no resemblance to the pictures produced by endoanal ultrasound. The inverted vectographs showed a much better correlation with endoanal ultrasound at each 0.5-mm level of the anal canal, for both squeeze pressure graphs and external sphincter correlations and for resting pressure graphs and internal sphincter correlations. CONCLUSIONS: Accurate assessment of sphincter integrity is not possible when interpreting the vectormanometry graphs in the current format; however, inverted vectorgraphy gives good correlations with endoanal ultrasound and provides combined functional (pressure measurement) and anatomic (three-dimensional profile) information regarding the anal canal.
Authors:
Geetinder Kaur; Angela Gardiner; Graeme S Duthie
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  49     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-10     Completed Date:  2006-09-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1160-6     Citation Subset:  IM    
Affiliation:
Academic Surgical Unit, University of Hull Postgraduate Medical School, Castle Hill Hospital, Cottingham, United Kingdom.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anal Canal / physiopathology*,  ultrasonography
Anus Diseases / physiopathology*,  ultrasonography
Constipation / physiopathology
Fecal Incontinence / physiopathology
Female
Humans
Male
Manometry / methods*
Middle Aged
Muscle Contraction
Pressure

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


Previous Document:  Radio frequency identification systems technology in the surgical setting.
Next Document:  Red hot chili pepper and hemorrhoids: the explosion of a myth: results of a prospective, randomized,...