Anal Canal Vector Volume Manometry

Schizas, Alexis; Emmanuel, Anton; Williams, Andrew B.

doi:10.1007/dcr.0b013e3182113be7

Cited by 17 publications

(4 citation statements)

References 45 publications

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“…Vector manometry is a quantitative measure of radial symmetry and volume of the anal sphincter. It involves withdrawing (commonly using a mechanical puller) a radially arranged multi‐channel anorectal manometry catheter through the length of the anal canal . The following parameters are identified: Radial asymmetry index (RAI) is a quantitative measure of the radial symmetry and can be calculated at any level in the anal canal but most commonly refers to the level at which the highest resting pressure is generated.…”

Section: Section 4: Anorectal Physiological Investigationsmentioning

confidence: 99%

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female anorectal dysfunction

Sultan

Monga

Lee³

et al. 2016

Neurourology and Urodynamics

102

154

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Section: Section 4: Anorectal Physiological Investigationsmentioning

confidence: 99%

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female anorectal dysfunction

Sultan

Monga

Lee³

et al. 2016

Neurourology and Urodynamics

102

154

View full text Add to dashboard Cite

show abstract

“…Lastly, we only used four manometric parameters (resting pressure, squeezing pressure, sphincter length and high‐pressure zone) from a range of parameters, which may introduce type II error. Some parameters, such as vector volume , sustained duration and rectoanal inhibitory reflex, were not measured in all patients due to differences in the protocols and software capabilities between each hospital.…”

Section: Discussionmentioning

confidence: 99%

Predictors of permanent stoma creation in patients with mid or low rectal cancer: results of a multicentre cohort study with preoperative evaluation of anal function

Kim

et al. 2019

Colorectal Disease

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Aim Preoperative factors predictive of permanent stoma creation were investigated in a long‐term follow‐up of patients with mid or low rectal cancer. Method We included patients who underwent radical resection for mid or low rectal cancer with available data for preoperative anal function measured by manometry and Faecal Incontinence Severity Index questionnaire between January 2005 and December 2015 in three tertiary referral hospitals. A permanent stoma was defined as a stoma present until the patient’s last follow‐up visit or death. Preoperative factors that predicted permanent stoma creation were analysed. Results Over a median follow‐up of 57.4 months (range 12–143 months), a permanent stoma was created in 144/577 (25.0%) patients, including 89 (15.4%) who underwent abdominoperineal resection, one (0.2%) who underwent Hartmann’s operation without reversal, 15 (2.6%) with a diverting ileostomy at the time of initial sphincter‐preserving surgery without undergoing stoma reversal, and 39 (6.8%) who underwent permanent ileostomy formation after sphincter‐preserving surgery. Patients with permanent stoma creation had a shorter tumour distance from the anal verge (P < 0.001), larger tumour size (P = 0.020) and higher preoperative Faecal Incontinence Severity Index score (P = 0.020). On multivariable analysis, tumour distance from the anal verge predicted permanent stoma formation (relative risk 0.53 per centimetre increase; 95% confidence interval 0.46–0.60; P < 0.001) but preoperative anal function did not. Conclusion Tumour distance from the anal verge was the only preoperative determinant of permanent stoma creation in rectal cancer patients. These data may help mid and low rectal cancer patients understand the need for permanent stoma.

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“…There are many advantages of recording anorectal pressure with the HDAM technique, 1) it utilizes solid state pressure sensors that have high fidelity, 2) it allows recording of pressures at high temporal and spatial resolution in both circumferential and axial direction, 3) pressures can be displayed as pseudo color plots, 4) one can calculate parameters such as length and area of the anal HPZ, which has been suggested to be different in patients as compared to normal subjects 19, 20 , (shorter in patients) and, 5) it is also possible to study movements of the anal HPZ that may have pathophysiological relevance. The location of peak pressure in the anal HPZ changes between rest and squeeze may vary because different muscles contribute to the rest and squeeze anal pressure.…”

Section: Discussionmentioning

confidence: 99%

A Predictive Model to Identify Patients With Fecal Incontinence Based on High-Definition Anorectal Manometry

Zifan

Ledgerwood-Lee

Mittal

2016

Clinical Gastroenterology and Hepatology

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Background & Aims Three-dimensional high-definition anorectal manometry (3D-HDAM) is used to assess anal sphincter function; it determines profiles of regional pressure distribution along the length and the circumference of the anal canal. There is no consensus, however, on the best way to analyze data from 3D-HDAM to distinguish healthy individuals from persons with sphincter dysfunction. We developed a computer analysis system to analyze 3D-HDAM data and to aid in the diagnosis and assessment of patients with fecal incontinence (FI). Methods In a prospective study, we performed 3D-HDAM analysis of 24 asymptomatic healthy subjects (controls; all women; mean age, 39±10 years) and 24 patients with symptoms of fecal incontinence symptoms (all women, mean age, 58±13 years). Patients completed a standardized questionnaire (fecal incontinence severity index to score the severity of FI symptoms. We developed and evaluated a robust prediction model to distinguish patient with FI from controls using linear discriminant, quadratic discriminant, and logistic regression analyses. In addition to collecting pressure information from the HDAM data, we assessed regional features based on shape characteristics and the anorectal symmetry index. Results Low FI severity index scores correlated with low rest pressure (r=0.34), and peak squeeze pressure of the anal canal(r=0.28). The combination of pressure values, anal sphincter area, and reflective symmetry values was identified in patients with FI vs controls with an area under the curve value of 1.0. In logistic regression analyses using different predictors, the model identified patients with FI with an area under the curve value of 0.96 (interquartile range [IQR], 0.22). In discriminant analysis, results were classified with a minimum error of 0.02, calculated using 10-fold cross validation; different combinations of predictors produced median classification errors of 0.16 in linear discriminant analysis (IQR, 0.25) and 0.08 in quadratic discriminant analysis (IQR, 0.25). Conclusion We developed and validated a novel prediction model to analyze 3D-HDAM data. This system can accurately distinguish patients with FI from controls.

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Anal Canal Vector Volume Manometry

Cited by 17 publications

References 45 publications

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female anorectal dysfunction

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female anorectal dysfunction

Predictors of permanent stoma creation in patients with mid or low rectal cancer: results of a multicentre cohort study with preoperative evaluation of anal function

A Predictive Model to Identify Patients With Fecal Incontinence Based on High-Definition Anorectal Manometry

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