High‐resolution anorectal manometry may probably be worth every penny

Vitton, Véronique; Benezech, Alban; Bouvier, Michel

doi:10.1111/nmo.13217

Cited by 5 publications

(3 citation statements)

References 9 publications

(1 reference statement)

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“…With the advent of HRAM-WP, the implementation and analysis of the method was greatly facilitated (7,8) . The immobilization of the probe after placement results in reduced discomfort, less presence of artefacts and short study time.…”

Section: Discussionmentioning

confidence: 99%

Water-Perfused High-Resolution Anorectal Manometry (Hram-Wp): The First Brazilian Study

Viebig¹,

Franco²,

Araujo³

et al. 2018

Arq. Gastroenterol.

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Section: Discussionmentioning

confidence: 99%

Water-Perfused High-Resolution Anorectal Manometry (Hram-Wp): The First Brazilian Study

Viebig¹,

Franco²,

Araujo³

et al. 2018

Arq. Gastroenterol.

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“…No obstante, no se ha demostrado todavía una ventaja adicional con respecto a la técnica convencional en el estudio de la IF y se ha puesto en duda su utilidad para diferenciar entre sujetos sanos y pacientes con defecación disinérgica hasta el punto de cuestionar la aportación real de esta tecnología 34,36 . Ello podría deberse, al menos en parte, a que se aplica la medición convencional a la MAR-AR y deben evaluarse otros nuevos parámetros con esta técnica 37 . Es pertinente mencionar que los parámetros apropiados para utilizar en la actualidad con estos sistemas se encuentran en desarrollo y evaluación por diversos grupos de investigación, y muchos de ellos no están listos para utilizarse en la práctica clínica, aunque aportan información muy relevante que permite redefinir la anatomía y fisiología anorrectal.…”

Section: Aspectos Clínicos Y Utilidad De La Mar-arunclassified

Manometría anorrectal: ¿alta resolución o alta definición? Pros y contras

Troche¹

2019

NGL

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Aspectos técnicos La manometría anorrectal (MAR) es una técnica que permite, mediante el registro simultáneo a diferentes niveles de los cambios de ABSTRACT Anorectal disorders can affect up to 15% of the population and are a consequence of neuromuscular alterations of the pelvic floor. The neurophysiological tests that evaluate the motor and sensory function of the anorectum provide very important information regarding the physiopathological mechanisms involved in anorectal disorders. Anorectal manometry (ARM) is considered the ideal test to evaluate the motor and sensory function of the anorectum. High resolution ARM (HR-ARM) and high definition (HD-ARM) are technologies that represent an evolution in the study of the physiology and anatomy of the structures involved in continence and evacuation. The objective of this review is to evaluate and compare HR-ARM, HD-ARM and conventional ARM in terms of its technological development, analysis and interpretation of these tests, as well as its usefulness in clinical practice. According to our review, HR-ARM and HD-ARM have greater recording capacity, are less variable, more reproducible, but also more expensive compared to conventional ARM. HD-ARM has the advantage of providing a reconstruction in 3 planes that could be compared with the endoanal ultrasound. It is important to mention that new parameters are being developed that will allow a better understanding of anorectal function, which probably leads to a reclassification of anorectal disorders. Up to now, HR-ARM and HD-ARM do not seem to have made a major diagnostic advance in routine clinical practice with respect to conventional ARM. This is an important issue to highlight since, in many parts of the world, the latter technology is the only one available and it is very useful.

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“…However, no additional benefits over the standard technique have been found for the study of fecal incontinence, and its role in discriminating healthy individuals from dyssynergic defecation patients has been questioned (21,25,47) to the point of doubting the actual contribution of this technology (48). This may be due, at least partly, to our using conventional metrics in HR-ARM, as newer parameters should be assessed with this approach (49). For instance, a phenotype classification has been suggested, which is difficult to apply in clinical practice (50).…”

Section: New Hr-arm and Hd-arm Parameters And Interpretationmentioning

confidence: 99%

High-resolution and high-definition anorectal manometry: rediscovering anorectal function

Ríos¹,

Mínguez²,

Remes-Troche³

et al. 2018

Rev Esp Enferm Dig

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assess anorectal function provides highly significant information on the pathophysiological mechanisms involved in the genesis of fecal incontinence, pelvic floor dyssynergia, rectal hypo-or hypersensitivity, and pelvic neuropathy (3). Anorectal manometry (ARM) is a technique that, by simultaneously recording intraluminal pressure changes at multiple levels, allows to assess anorectal motor activity both at rest and mimicking multiple physiological situations (rectoanal inhibitory reflex, retention effort, defecation maneuver, Valsalva reflex). While barostat represent the gold standard in the evaluation of rectal sensitivity, ARM may also assess it provided the device is fitted with a distensible rectal balloon. This technique, together with balloon expulsion testing, is used in standard clinical practice for the diagnosis of defecatory disorders in patients with constipation refractory to standard therapy with hygienic-dietary measures and laxatives (4), in the assessment of patients with fecal incontinence (5), to administer biofeedback therapy to patients with constipation and/or fecal incontinence, in the assessment of anorectal pain syndromes (proctalgia), and even for the preoperative and postoperative evaluation of ileorectal anastomoses (6). High-resolution anorectal manometry (HR-ARM) and high-definition anorectal manometry (HD-ARM), available since 2007, are increasingly used in clinical practice. In comparison to the conventional technique, HR-ARM and HD-ARM catheters provide a greater number of recording points thanks to their multiple, closely packed circumferential sensors. This allows time-space visualization (topograph

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High‐resolution anorectal manometry may probably be worth every penny

Cited by 5 publications

References 9 publications

Water-Perfused High-Resolution Anorectal Manometry (Hram-Wp): The First Brazilian Study

Water-Perfused High-Resolution Anorectal Manometry (Hram-Wp): The First Brazilian Study

Manometría anorrectal: ¿alta resolución o alta definición? Pros y contras

High-resolution and high-definition anorectal manometry: rediscovering anorectal function

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