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  • 1
    Electronic Resource
    Electronic Resource
    Comparison of precontract, postcontrast, and delayed CT scanning for the staging of rectal carcinoma (1992)
    Springer
    Abdominal imaging 17 (1992), S. 267-270 
    Details
    ISSN: 1432-0509
    Keywords: Rectal carcinoma, CT ; Contrast media
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An attempt is made to establish the most appropriate examination procedure for staging rectal carcinoma by computed tomography (CT). Twentytwo patients with rectal carcinoma had CT performed preoperatively. The following three CT sequences were performed in all patients: a precontrast scan with 10-mm slices; a rapid sequence scan with 5-mm slices during bolus injection of contrast medium; and a postcontrast scan after a 10-min delay. Tumor extension and the presence of perirectal lymph nodes were evaluated separately and independently in all three CT sequences according to the TNM classification. All patients had surgical follow-up and the CT scans were compared to the surgical and histopathological findings. There was no significant difference in diagnostic outcome in the three CT procedures. Information obtained by frontal and lateral scout views were compared, and the lateral scout view proved more informative than the frontal scout view. For staging rectal carcinoma, narrow slice scanning and intravenous contrast media are superfluous and should be reserved for special cases. We recommend the use of lateral scout views.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01888564
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  • 2
    Electronic Resource
    Electronic Resource
    Risk of sphincter damage and anal incontinence after anal dilatation for fissure-in-ano (1993)
    Springer
    Diseases of the colon & rectum 36 (1993), S. 677-680 
    Details
    ISSN: 1530-0358
    Keywords: Anal dilatation ; Anal sphincter damage ; Endosonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Follow-up was performed two to six years after anal dilatation for fissure-in-ano in 32 consecutive patients who had not undergone additional anal surgery. All patients were interviewed and asked specifically about impairment of flatus or fecal control and its possible relation to the anal dilatation. Anal dilatation was followed by minor anal incontinence in 12.5 percent of the patients. Anal endosonographic follow-up was accepted by 20 patients, and sphincteric defects were found in 13 (65 percent) of those. Two patients with anal incontinence had internal sphincter defects. Sphincteric defects were also found in 11 of the 18 continent patients who underwent sonography: internal sphincter defects in nine, external sphincter defect in one, and combined defects of both sphincter muscles in one. In conclusion, anal dilatation results in sphincter damage in more than half of patients, but few of them develop anal incontinence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02238595
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Rectal endosonography in the evaluation of stenotic rectal tumors (1993)
    Springer
    Diseases of the colon & rectum 36 (1993), S. 275-279 
    Details
    ISSN: 1530-0358
    Keywords: Rectal cancer ; Endosonography ; Stenosis ; Preoperative staging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Preoperative evaluation of stenotic rectal tumors is important since they often involve adjacent organs and thus may require additional therapy. Previous reports on endosonographic staging have excluded stenotic tumors because they could not be fully visualized with the available equipment. In this study, we have evaluated the role of endosonography in staging stenotic rectal tumors, with special attention to the use of forward-looking endoprobes. Preoperative staging was performed in 28 patients with stenotic rectal tumors. Tumor extension was evaluated according to the TNM classification, and the results were compared with surgical and histopathologic findings. Endosonography accurately assessed tumor extension in two T2 tumors, 14 T3 tumors, and seven T4 tumors. Three T2 tumors were overstaged, and two T4 tumors were staged as T3. The accuracy was 82 percent. Twenty-two tumors were subject to histopathologic evaluation of lymph nodes. Lymph nodes larger than 1 cm had been seen by endosonography in eight patients, five of whom had nodal metastases. Lymph nodes smaller than 1 cm or no lymph nodes were found in 14 patients, four of whom had nodal metastases. In conclusion, full sonographic visualization of stenotic rectal tumors and thus evaluation of tumor extension can be achieved by using forwardlooking endoprobes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02053510
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  • 4
    Electronic Resource
    Electronic Resource
    Defecographic findings in patients with anal incontinence and constipation and their relation to rectal emptying (1993)
    Springer
    Diseases of the colon & rectum 36 (1993), S. 806-809 
    Details
    ISSN: 1530-0358
    Keywords: Defecography ; Anal incontinence ; Constipation ; Rectal evacuation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The aim of this study was to examine defecographic findings in patients with anal incontinence and constipation and to compare these findings with rectal emptying. METHODS: One hundred seventy-five preoperative defecographies documented on videotape in patients with either anal incontinence or constipation were retrospectively reviewed. The examinations were evaluated with respect to anatomic abnormalities of the rectum or anal canal. The results were compared with a semiquantitative assessment of rectal emptying as it appeared on the video sequence after one minute of strain. RESULTS: Anatomic abnormalities were found equally in incontinent and constipated patients, except for failure to open the anal canal, which was found only in constipated patients. Rectal intussusception was the most frequent finding. Abnormal defecograms were found in both sexes. Enteroceles, sigmoidoceles, and large rectoceles were found only in women. The presence of intussusception, lacking relaxation of the puborectalis muscle, and rectocele did not correlate with poor rectal emptying. Poor rectal emptying was also found in 19 of 58 patients with normal defecograms. CONCLUSIONS: Anatomic abnormalities of the rectum may be demonstrated independently of the clinical symptoms and are not always correlated to impaired rectal emptying. Since they may also be found in healthy controls, surgical correction of these abnormalities should be considered only with great caution.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02047375
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  • 5
    Electronic Resource
    Electronic Resource
    Endosonographic assessment of the anal sphincter after surgical reconstruction (1994)
    Springer
    Diseases of the colon & rectum 37 (1994), S. 434-438 
    Details
    ISSN: 1530-0358
    Keywords: Anal sphincter ; Anal sphincter reconstruction ; Endosonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Patients with anal incontinence attributable to trauma are usually treated by sphincter reconstruction. Failures because of incomplete reconstruction may possibly be detected by anal endosonography which gives detailed information on the anal sphincter muscles. The aim of this study was to describe the endosonographic findings in patients after sphincter reconstruction. MATERIALS AND METHODS: Ten female patients who had undergone surgical sphincter reconstruction using an overlapping technique because of anal incontinence were studied with anal endosonography a median of six months after surgery. Five patients were fully continent, three were incontinent for flatus, and two patients were still incontinent for solid stool at the time of this study. Eight patients had also been studied with endosonography before surgery, and, in these patients, we compared the initial sonograms with the follow-up sonograms. The angular extent of the endosonographic defects in the external sphincter before and after reconstruction was measured in degrees and compared with the outcome of surgery. RESULTS: After reconstruction, continuity of the external anal sphincter was completely restored at all levels in four patients, one of whom still had anal incontinence. Continuity was partially restored in three patients: two were fully continent, while one patient, previously incontinent for stool, was incontinent for flatus. In three patients the continuity was restored at one level but a persisting defect was found at a different level. In two of these patients the grade of incontinence was unchanged. Three patients also had defects in the internal anal sphincter. CONCLUSION: After surgical sphincter reconstruction for anal incontinence, we found sphincteric defects in six patients, including four of five patients who still had some degree of incontinence. Thus, endosonography may be used for postoperative assessment and may explain the unsatisfactory results of surgery in some patients. We recommend that endosonography be also performed preoperatively, whereby the effect of the operation on the size of the sphincteric defect can be assessed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02076187
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  • 6
    Electronic Resource
    Electronic Resource
    Electromyography of the internal anal sphincter performed under endosonographic guidance description of a new method (1994)
    Springer
    Diseases of the colon & rectum 37 (1994), S. 138-143 
    Details
    ISSN: 1530-0358
    Keywords: Electromyography ; Endosonography ; Internal anal sphincter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The aim of our study was to investigate internal anal sphincter electromyographic signals. METHODS: Electromyography of the internal anal sphincter was performed with platinum wire electrodes in six healthy volunteers (three males and three females), inserted under endosonographic guidance. Platinum wire electrodes were also inserted into the external anal sphincter. Activity of both the internal and external anal sphincter in a 40-second period was measured. RESULTS: Internal anal sphincter median activity was 22.1 (range, 5.5–67.6) μ V. Slow-wave activity was 47 cycles/minute (range, 34–55 cycles/minute). After inflation of a rectal balloon with air until a constant relaxation of the anal canal was obtained, a decrease in internal anal sphincter activity to 15.9 (1.2–31.3) μV as well as a decrease in slow-wave activity to 34 cycles/minute (range, 27–40 cycles/minute) was found. The original internal anal sphincter EMG was resumed after deflation of the rectal balloon. External anal sphincter median activity was 31 (range, 0.77–18.6)μV. During inflation of the rectal balloon, a reflex increase in external sphincter EMG activity was found. With the rectal balloon fully inflated a part of this increase was still present, 11.0 (1.9–24.6)μV. In some of the subjects, this increased activity was superimposed on the internal anal sphincter recordings as well. During a voluntary squeeze it was not possible to identify internal anal sphincter activity due to activity of the external anal sphincter totally overriding the internal anal sphincter signal. CONCLUSION: Precise EMG recordings from the internal anal sphincter is possible with endosonographic guidance of the electrodes, except during voluntary squeezing of the external anal sphincter.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02047535
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