title: Influence of Parks' anal retractor on anal sphincter pressures.
abstract: OBJECTIVE
  The effects of the Parks' anal retractor on anal sphincter function were studied in a prospective, randomized trial. A closed hemorrhoidectomy was performed intra-anally in 20 patients using the Parks' anal retractor; in 20 other patients, the procedure was done perineally without the use of a retractor.
  
  
  METHODS
  Anal manometry was performed before and at 6 and 12 weeks after hemorrhoidectomy.
  
  
  RESULTS
  Mean squeeze pressure decreased by 4 percent whether or not a retractor was used. Mean resting pressure decreased by 23 percent after use of Parks' anal retractor (P = 0.01) compared with 8 percent when it was not used (P > 0,05).
  
  
  CONCLUSIONS
  The internal anal sphincter is easily damaged with the use of the Parks' anal retractor. When possible, its use should be avoided to obtain better manometric and functional results.
authors.affiliation: The Department of Surgery, Lukas-Andreas Hospital, Amsterdam, The Netherlands.
authors.forename: W F
authors.initials: WF
authors.lastname: van Tets
authors.forename: J H
authors.initials: JH
authors.lastname: Kuijpers
authors.forename: K
authors.initials: K
authors.lastname: Tran
authors.forename: R
authors.initials: R
authors.lastname: Mollen
authors.forename: H
authors.initials: H
authors.lastname: van Goor
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000502:physiology*; D003107:Colorectal Surgery / Q000295:instrumentation*; D005242:Fecal Incontinence; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011183:Postoperative Complications; D011312:Pressure; D011446:Prospective Studies; D013525:Surgical Instruments