[Abdominal rectopexy in the treatment of rectal prolapse: how to foresee the functional result].
21 patients (19 women) who underwent rectal prolapse repair were prospectively studied. At the one year follow-up, 6 of the eleven incontinent patients (54 per cent) regained full continence and while three of the remaining 5 patients improved they still referred occasional imperfection of continence. Resting anal pressure and maximal squeeze pressure were both significantly lower in the five patients who remained incontinent, 23 (17-31) mm Hg vs 50 (31-52) mm Hg (p < = 0.02) and 52 (17-75) mm Hg vs 108 (89-110) mm Hg (p < = 0.02), respectively. Moreover the manometric results showed evidence that in patients who remained incontinent, the anal pressure in response to rectal distention, was significantly lower than patients who regained continence (p < = 0.05) both before and after operation. We conclude that incontinent patients with rectal prolapse who exhibit a markedly low minimal residual anal pressure on recto-anal reflex inhibition are less likely to improve after rectopexy and that this preoperative test may be a useful predictor.
Istituto di Patologia Chirurgica, Cattedra di Chirurgia Generale, Università di Verona.
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Delaini
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Scaglia
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Hulten
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000503:physiopathology; D005242:Fecal Incontinence / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012005:Rectal Prolapse / Q000503:physiopathology* / Q000601:surgery*; D012007:Rectum / Q000503:physiopathology / Q000601:surgery*; D012018:Reflex; D013997:Time Factors
Rettopessia addominale per il trattamento del prolasso del retto: come prevedere il risultato funzionale.