The usefulness of anorectal manometry in patients with a stoma before and after surgery to restore the continuity of the gastrointestinal tract

Abstract

The operation to restore the continuity of the gastrointestinal tract is another surgical intervention in a given patient, which directly translates into an increased risk of complications during and after surgery. That is why proper qualification is important for the operation to restore the continuity of the gastrointestinal tract in terms of performance and efficiency of the anal sphincter apparatus, among other things. The aim of the study was to evaluate the effect of restoring physiological defecation routes on the sphincter function and to observe the parameters of anorectal manometry in patients before and after surgery to restore the continuity of the gastrointestinal tract. material and methods. The study included 29 patients scheduled for restoration of the continuity of the gastrointestinal tract, 12 women and 17 men. The average age in the group was 62 years. Anorectal manometry was performed both before surgery as well as one month and three months afterwards in all patients. The average time to have a stoma was 12 months. Results. The resting pressure in the anal canal (MRP) three months after the restoration of the continuity of the gastrointestinal tract increased by 30.4%. The maximum systolic blood pressure in the anal canal (MSP) increased by 22.2%. The value of recto-anal inhibitory reflex (RAIR) decreased by 19.2%. The length of the high pressure zone in the anal canal (HPZL) increased by 27%. The study results of visceral rectal sensation thresholds decreased by 23.3% for the sensation threshold, and 14.4% for the pressure threshold. conclusions. Restoring the continuity of the gastrointestinal tract improves the anal sphincter function which is evident in the parameters of anorectal manometry. The restoration of passage improves the sphincter function, and these changes are statistically significant.

Application of Pelvic Peritoneum Closure Combined with Extraperitoneal Colostomy in Laparoscopic Surgery for Low Rectal Cancer

“…Thus, further clinical research is necessary. Similar results have been observed by Tomasz [14] . (2) The intestinal stoma and peritubular tissue may become connected and fixed, supporting and stabilizing the tunnel colon and decreasing retraction or prolapse of the colostomy tube.…”

Risk Factors of Delayed Recovery of Gastrointestinal Function After Ileostomy Reversal for Rectal Cancer Patients

“…The duration from the primary operation to the restoration of gastrointestinal tract continuity may vary considerably as it depends on the tumor status, pelvic floor function and the patient’s condition. 27 The present study showed that the average time between the primary operation and the closure of the ileostomy was 171 days, which was similar to a study by Law et al (183 days). 28 Furthermore, in this study, we found that the duration of stoma ≥6 months was another independent risk factor for delayed flatus.…”

Effect of neoadjuvant chemoradiation on anorectal function assessed with anorectal manometry: A systematic review and meta-analysis

“…Two investigators (PM and MIH) independently assessed the methodological quality of the studies using the Newcastle–Ottawa Scale (NOS). 19 The scoring system covers eight items related to three major domains (selection of exposed and non-exposed cohorts, comparability and outcome assessment).…”

“…Anorectal manometry (ARM) measures the pressure in the rectum/anal canal through a pressure transducer. 19 ARM can objectively assess the quality of the continence mechanism, as it can identify functional sphincter weakness and rectal compliance and can be used to evaluate alternative procedures to stoma. 20 , 21 However, ARM technology (i.e., type of probes), methodology and protocols (i.e., timing of execution), and investigated parameters are not yet standardized in the literature.…”