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Article: Earlier appearance and higher incidence of the rectoanal relaxation reflex in patients with imperforate anus repaired with laparoscopically assisted anorectoplasty

TitleEarlier appearance and higher incidence of the rectoanal relaxation reflex in patients with imperforate anus repaired with laparoscopically assisted anorectoplasty
Authors
KeywordsAnorectal manometry
Imperforate anus
Laparoscopically assisted anorectoplasty
Posterior sagittal anorectoplasty
Rectoanal relaxation reflex
Issue Date2003
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/
Citation
Surgical Endoscopy And Other Interventional Techniques, 2003, v. 17 n. 10, p. 1646-1649 How to Cite?
AbstractBackground: This study aimed to evaluate clinically and manometrically the anorectal function of patients with imperforate anus after repair with laparoscopically assisted anorectoplasty (LAR), as compared with the function of patients after undergoing the conventional method, posterior sagittal anorectoplasty (PSARP). Methods: The defecation status and anorectal manometry of patients with high or intermediate type imperforate anus repaired with LAR (n = 9) and age-matched patients repaired with PSARP (n = 13) were assessed and compared during the first year of postoperative follow-up evaluation. The defecation status was classified by the frequency of bowel openings (< 1, 1-4, and >5 times per day). Manometric assessment was performed by an open-tip hydraulic capillary infusion system. The presence of the rectoanal relaxation reflex was determined, and the resting sphincteric pressure and resting rectal pressure were measured. Results: Seven of nine LAR patients had an "acceptable" frequency of one to four bowel openings per day, in contrast to 7 of 13 PSARP patients. The difference in the presentation of daily stooling is not significant (p > 0.05). A positive RAR was detected in 88.9% (8/9) of the LAR patients, and in only 30.8% (4/13) of the PSARP patients (p < 0.01). The presence of a rectoanal relaxation reflex also significantly correlated with an acceptable frequency of bowel opening (1-4 times per day) in both LAR and PSARP patients (p < 0.05). Moreover, a rectoanal relaxation reflex was detected significantly earlier in LAR than in PSARP patients (4.9 ± 1.2 vs 10.1 ± 2.5 months; postoperatively p < 0.0001). Both the LAR and PSARP patients had a similar resting sphincteric pressure (21.5 ± 4.7 vs 25.4 ± 6.2 cm H2O; p > 0.05). By contrast, the resting rectal pressure was significantly lower in LAR than in PSARP patients (7.7 ± 1.5 vs 11.5 ± 1.3 cmH2O; p < 0.05). Conclusions: In the early postoperative stage, patients repaired with LAR had more favorable findings in anorectal manometry than patients repaired with PSARP. Long-term follow-up studies to confirm a superior defecation continence achieved with LAR are warranted.
Persistent Identifierhttp://hdl.handle.net/10722/92260
ISSN
2015 Impact Factor: 3.54
2015 SCImago Journal Rankings: 1.695
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLin, CLen_HK
dc.contributor.authorWong, KKYen_HK
dc.contributor.authorLan, LCLen_HK
dc.contributor.authorChen, CCen_HK
dc.contributor.authorTam, PKHen_HK
dc.date.accessioned2010-09-17T10:40:47Z-
dc.date.available2010-09-17T10:40:47Z-
dc.date.issued2003en_HK
dc.identifier.citationSurgical Endoscopy And Other Interventional Techniques, 2003, v. 17 n. 10, p. 1646-1649en_HK
dc.identifier.issn0930-2794en_HK
dc.identifier.urihttp://hdl.handle.net/10722/92260-
dc.description.abstractBackground: This study aimed to evaluate clinically and manometrically the anorectal function of patients with imperforate anus after repair with laparoscopically assisted anorectoplasty (LAR), as compared with the function of patients after undergoing the conventional method, posterior sagittal anorectoplasty (PSARP). Methods: The defecation status and anorectal manometry of patients with high or intermediate type imperforate anus repaired with LAR (n = 9) and age-matched patients repaired with PSARP (n = 13) were assessed and compared during the first year of postoperative follow-up evaluation. The defecation status was classified by the frequency of bowel openings (< 1, 1-4, and >5 times per day). Manometric assessment was performed by an open-tip hydraulic capillary infusion system. The presence of the rectoanal relaxation reflex was determined, and the resting sphincteric pressure and resting rectal pressure were measured. Results: Seven of nine LAR patients had an "acceptable" frequency of one to four bowel openings per day, in contrast to 7 of 13 PSARP patients. The difference in the presentation of daily stooling is not significant (p > 0.05). A positive RAR was detected in 88.9% (8/9) of the LAR patients, and in only 30.8% (4/13) of the PSARP patients (p < 0.01). The presence of a rectoanal relaxation reflex also significantly correlated with an acceptable frequency of bowel opening (1-4 times per day) in both LAR and PSARP patients (p < 0.05). Moreover, a rectoanal relaxation reflex was detected significantly earlier in LAR than in PSARP patients (4.9 ± 1.2 vs 10.1 ± 2.5 months; postoperatively p < 0.0001). Both the LAR and PSARP patients had a similar resting sphincteric pressure (21.5 ± 4.7 vs 25.4 ± 6.2 cm H2O; p > 0.05). By contrast, the resting rectal pressure was significantly lower in LAR than in PSARP patients (7.7 ± 1.5 vs 11.5 ± 1.3 cmH2O; p < 0.05). Conclusions: In the early postoperative stage, patients repaired with LAR had more favorable findings in anorectal manometry than patients repaired with PSARP. Long-term follow-up studies to confirm a superior defecation continence achieved with LAR are warranted.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/en_HK
dc.relation.ispartofSurgical Endoscopy and Other Interventional Techniquesen_HK
dc.subjectAnorectal manometryen_HK
dc.subjectImperforate anusen_HK
dc.subjectLaparoscopically assisted anorectoplastyen_HK
dc.subjectPosterior sagittal anorectoplastyen_HK
dc.subjectRectoanal relaxation reflexen_HK
dc.titleEarlier appearance and higher incidence of the rectoanal relaxation reflex in patients with imperforate anus repaired with laparoscopically assisted anorectoplastyen_HK
dc.typeArticleen_HK
dc.identifier.emailWong, KKY: kkywong@hkucc.hku.hken_HK
dc.identifier.emailTam, PKH: paultam@hkucc.hku.hken_HK
dc.identifier.authorityWong, KKY=rp01392en_HK
dc.identifier.authorityTam, PKH=rp00060en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1007/s00464-002-9246-3en_HK
dc.identifier.pmid12915967-
dc.identifier.scopuseid_2-s2.0-0345446640en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0345446640&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume17en_HK
dc.identifier.issue10en_HK
dc.identifier.spage1646en_HK
dc.identifier.epage1649en_HK
dc.identifier.eissn1432-2218-
dc.identifier.isiWOS:000187309300029-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLin, CL=27169299500en_HK
dc.identifier.scopusauthoridWong, KKY=24438686400en_HK
dc.identifier.scopusauthoridLan, LCL=7005687228en_HK
dc.identifier.scopusauthoridChen, CC=7501960062en_HK
dc.identifier.scopusauthoridTam, PKH=7202539421en_HK

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