Evaluation of vector manometry for characterization of functional outcome after restorative proctocolectomy

Abstract

A strong anal sphincter at rest and a consistent radial distribution of the sphincter pressure are the most reliable indicators of continence after RP obtained by VM, but their clinical usefulness is limited.

Ileal Pouch Anal Anastomosis with Close Rectal Dissection Using Automated Vessel Sealers for Ulcerative Colitis: A Promising Alternative

“…The first sense, first urge, and maximum tolerated volumes of the pouch are closely related to the functional outcome [26]. Therefore, the significantly increased volumes of these parameters in our population support a good functional outcome.…”

Anal Canal Vector Volume Manometry

“…25 After low anterior resection, low resting vector volumes and decreased symmetry have been shown to correlate with postoperative continence. 23 Better correlation with continence was found using the continuous pull-through than with the station pull-through technique. 23 Radiotherapy significantly decreases continence after rectal resection, 35 with resting pressures and resting vector volume decreasing significantly in patients with rectal cancer who have fulldose postoperative radiotherapy.…”

“…23 Better correlation with continence was found using the continuous pull-through than with the station pull-through technique. 23 Radiotherapy significantly decreases continence after rectal resection, 35 with resting pressures and resting vector volume decreasing significantly in patients with rectal cancer who have fulldose postoperative radiotherapy. 35,36 Vector volume symmetry in patients after rectal cancer resection, at rest and on squeezing, was significantly lower in patients with incontinence compared with patients who were continent.…”

“…In addition to the association with AES, vector manometry has been shown to correlate with symptoms after rectal and anal surgery. 23,33,34 Therefore, the role of vector manometry may well be in the preoperative assessment of patients with rectal and anal pathology. The information provided by the preoperative vector manometry may aid in the prediction of postoperative functional changes; for example, in the preoperative assessment of patients with anal fistula or anal fissures where sphincter division may be performed, or in patients with a rectal prolapsed or low rectal tumor where fecal incontinence may be a significant postoperative complication.…”

“…This is commonly marked on the vector profile when the pressure reading is zero at all the channels. 8,22,23,25,33,34,45,46 The pressure at the anal verge is not necessarily zero, because the buttocks will press on the catheter, giving a pressure reading, especially on active contraction. This will lead to discrepancies in the volume of pressure measured and the vector symmetry over the length of the anal canal.…”