Before and after Anorectal Surgery: Which Information Is Needed from the Functional Laboratory

Abstract

Background: Anorectal surgery covers a wide spectrum of surgery. Diagnostic workup of anorectal disease is based on clinical examination with basic functional tests followed by more elaborate diagnostic tests. Since the incidence of anorectal disorders increases with age, more patients will present in outpatient clinics, thus underlining the relevance of this topic. Methods: A PubMed literature search was performed using the terms ‘anal incontinence', ‘anal and rectal surgery', ‘functional diagnostics', and combinations of these terms. No restriction regarding publication year or publication type was applied but randomized trials, ‘metanalyses', or guidelines were ranked higher. Only articles in English or German were included. Results: The diagnostic value of digital rectal examination, anal manometry and endosonography, the water holding procedure, contrast enema, and incontinence scores is summarized. Conclusion: The article focusses on basic clinical and functional diagnostic tests which can be easily applied in the pre- and postoperative setting to evaluate the postoperative outcome.

Functional Diagnosis in Upper and Lower Gastrointestinal Diseases: Relevance for Conservative, Interdisciplinary and Surgical Therapies

“…Witte et al [7] as well as Heinrich and Misselwitz [8] discuss the information needed from the functional laboratory before and after surgery. Furthermore, Heinrich and Misselwitz [8] place emphasis on the role of high-resolution anorectal manometry as a promising new tool in the diagnosis of functional anorectal disorders.…”

Functional Diagnosis in Upper and Lower Gastrointestinal Diseases: Relevance for Conservative, Interdisciplinary and Surgical Therapies

“…Anorectal surgery covers a wide spectrum of surgery from operations for hemorrhoids to intersphincteric resection for low rectal cancer. Witte et al [7] as well as Heinrich and Misselwitz [8] discuss the information needed from the functional laboratory before and after surgery. Furthermore, Heinrich and Misselwitz [8] place emphasis on the role of high-resolution anorectal manometry as a promising new tool in the diagnosis of functional anorectal disorders.…”