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  • 1
    Electronic Resource
    Electronic Resource
    Role of proctography in severe constipation (1990)
    Springer
    Diseases of the colon & rectum 33 (1990), S. 707-712 
    Details
    ISSN: 1530-0358
    Keywords: Constipation ; Anorectal Manometry ; Proctogram ; Rectum ; Anorectal angle
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract As referred to in the literature, patients complaining of constipation may have a spastic or, in the case of chronic straining, weak pelvic floor. Twenty-two severely constipated patients who did not improve after a high fiber diet were submitted to whole gut transit time (TT), proctographic, and anorectal manometric studies. A control group consisting of five subjects for TT, five subjects for proctogram, and ten subjects for manometry was also studied. Transit time was delayed ( P 〈 0.001) in all patients. Manometry in the constipated group showed a high rectal threshold (64.1 vs. 17.1 ml of air,P 〈 0.01), but no other significant difference. Proctograms in 10 of 22 patients (Group A) showed no differences in the anorectal angle (ARA) and in its distance from the pubococcygeal line (DLPC) in respect to the control group; 12 of 22 patients (Group B) had a paradoxical closure of the ARA at straining in respect to resting position (101.2† vs. 120.1†), and a higher DLPC than Group A and the control group in all positions studied. There was no difference in TT for rectal stasis of radiopaque markers between the two pathologic groups. Patients in Group B were older than patients in Group A (55.3 vs. 42.9 years,P 〈0.05). In conclusion, proctograms showed alterations of the pelvic floor, but there was no correlation between proctographic data and rectal or colonic stasis of the radiopaque markers, or clinic severity of constipation, but a correlation between ages did exist.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02150750
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  • 2
    Electronic Resource
    Electronic Resource
    Striated anal sphincter electromyography in idiopathic fecal incontinence (1995)
    Springer
    Diseases of the colon & rectum 38 (1995), S. 27-31 
    Details
    ISSN: 1530-0358
    Keywords: Sphincter electromyography ; Idiopathic fecal incontinence ; Anal manometry ; Anal sphincter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: This study was designed to determine the importance of innervation of striated anal sphincters, one of the most important structures in idiopathic fecal incontinence. METHODS: Forty-three idiopathic, fecally incontinent patients (40 women and 3 men; mean age, 57.2±11 (range, 33–77) years) underwent anorectal manometry and sphincteric electromyography. On the basis of electromyographic findings, patients were subdivided into three groups: Group A consisted of 21 patients with normal electromyography; Group B consisted of 14 patients with moderate denervation; Group C consisted of 8 patients with severe denervation. Manometric results from the patients were compared with those from 15 healthy subjects (8 women and 7 men; mean age, 35±12 (range, 15–55) years). RESULTS: Incontinent patients had a shorter anal canal (P =0.005), and anal canal pressure was lower at rest (P 〈0.001), at contraction (P 〈0.001), and at coughing (P 〈0.001); rectal distention and rectal compliance were reduced (maximum tolerated volume,P 〈0.003; compliance at 200 ml,P =0.03; at 250,P 〈0.005; at 300 ml,P =0.03). No statistically significant differences were found between the manometric results of the three different groups of patients. A statistically significant linear correlation was reached by comparing the clinical severity of fecal incontinence with age (P =0.02) and some other manometric parameters: the pressure of the anal canal at rest (P 〈0.001) and at contraction (P 〈0.01); rectal compliance at 50 ml (P =0.03), 100 ml (P =0.004), and 150 ml (P =0.004). CONCLUSION: Clinical severity of fecal incontinence is correlated with some manometric parameters. Severity of denervation of the anal striated sphincters does not appear to influence severity of fecal incontinence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02053853
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  • 3
    Electronic Resource
    Electronic Resource
    Sarafoff's anoplasty for incontincence following Whitehead's haemorrhoidectomy (1999)
    Springer
    Techniques in coloproctology 3 (1999), S. 63-66 
    Details
    ISSN: 1128-045X
    Keywords: Key words Sarafoff's anoplasty ; Whitehead's haemorrhoidectomy ; Anal manometry ; Faecal incontinence ; Anal prolapse ; Ectropion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The purpose of our study was to ascertain whether Sarafoff's anoplasty is a valid option for anal ectropion (eversion), in which mucosal prolapse causes continuous mucus discharge and faecal incontinence from loss of sensitivity due to anal skin removal. A retrospective evaluation was made of 12 patients (8 female and 4 male, mean follow-up time 8.3 years, range 2–12 years) who, from 1984 through 1997, underwent Sarafoff's anoplasty for anal ectropion following Whitehead's haemorroidectomy, which in 5 cases had been combined with prolapsectomy. Eight patients complained of incontinence to solid faeces (Miller's score 7–9), and the remaining 4 of incontinence to liquid faeces and gas (Miller's score 1–6). The median score for preoperative incontincence was 7. All patients underwent pre- and postoperative manometric evaluation. Sarafoff's anoplasty consists of a cutaneous and subcutaneous circular incision to a depth equal to that of the sphincteric apparatus (1–4 cm), and at a distance of 1–2 cm from the everted anal or rectal mucosa, with analcoccygeal ligament sectioning. The wound created is made to heal without sutures. Scar retraction, together perhaps with the action of the levator ani muscle, raises the eversion, thus restoring the anoderm of the distal anal canal. On comparing values before and after Sarafoff's anoplasty, a significant improvement was found in: mucus secretion (P 〈 0.01), ectropion (P 〈 0.01), and degree of postoperative continence, with a median score of 2 (P 〈 0.01). No statistical difference was found between mean manometric parameters before and after surgery. Sarafoff's anoplasty in selected patients with ectropion combined with faecal incontinence due to loss of anal sensitivity, is a simple procedure with good long-term results, and without important complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s101510050016
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    Paper (German National Licenses)
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