Differences Between Conventional Anorectal Manometry and High Resolution/High Definition Anorectal Manometry

Torresan, F.; Mandolesi, Daniele; Bonventre, Sebastiano; Usai-Satta, Paolo

doi:10.1007/978-3-030-32419-3_5

Cited by 3 publications

(1 citation statement)

References 57 publications

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“…The functional evaluation was completed by the execution of high-resolution and high-definition anorectal manometry) that provides a detailed topographic and colorimetric mapping of the anorectal sphincter complex and offers a more intuitive evaluation of the anorectal function without the need for pull-through of the catheter. This novel technology provides colour-countered topographic plots based on amplitude, distance, and time, depicting a continuum of dynamic pressure changes along lengths and time; data are presented in a simplified manner, in contrast to the use of linear plots of amplitude signals alone in conventional manometry [ 26 ] (Fig. 1 ).…”

Section: Methodsmentioning

confidence: 99%

Autologous adipose-derived stromal vascular fraction and platelet concentrates for the treatment of complex perianal fistulas

et al. 2022

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Background Complex perianal fistulas are a major challenge for modern surgery since 10–35% of patients have functional problems after treatment. Sphincter-saving techniques have a wide range of efficacy (10–80%). We hypothesised that autologous adipose-derived stromal vascular fraction in combination with platelet rich plasma is a new therapeutic strategy with enhanced cure and function preservation rates. Methods Adult patients with complex cryptoglandular perianal fistulas were treated with injection of autologous adipose-derived stromal vascular fraction in combination with platelet rich plasma around and inside the fistulous tract between May 2018 and April 2019 at the General and Emergency Surgery Operative Unit of the University Hospital “P. Giaccone” of Palermo. Fistulas were confirmed by magnetic resonance imaging. Patients completed the Short Form-36 score on quality of life and the Wexner and Vaizey scores on faecal incontinence, and they were functionally studied using a three-dimensional anorectal manometry. The clinical and functional follow-up was performed at 1 year and 2 years after surgery. Results Nine patients (4 males, 5 females; median age 42 years [19–63 years]) with high trans-sphincteric or horseshoe fistulas were treated. The average number of previous surgeries per patient was 4.8. At 1 year follow-up, 77.7% of patients were cured, while at 2 years there was 1case of relapse. The variation in Short Form-36 score in cured patients was not significant (p = 0.0936). No statistically significant differences were found in continence scores. Conclusions The proposed treatment is a treatment option that preserves sphincter integrity and function, potentially avoiding postoperative incontinence and the need of repeated treatments.

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Section: Methodsmentioning

confidence: 99%