Fecoflowmetric profiles in postoperative patients with Hirschsprung's disease.
OBJECTIVE
The objective of this study is to evaluate the anorectal function from the viewpoint of fecoflowmetry in postoperative patients with Hirschsprung's disease (HD).


METHODS
This study evaluated 23 long-term follow-up patients who had undergone a radical operation for HD. Their mean age was 11 years. The types of HD included rectosigmoid colon type, 18 cases, and entire colon type, 5 cases. An anorectal manometric study was performed before fecoflowmetry. After normal saline solution was administrated as an imitation stool into the rectal cavity under pressure monitoring, the patients defecated on a fecoflowmeter. After discussing the maximum defecation flow (Flow-max), fecoflow pattern (FFP), tolerance rate (TR), anal canal pressure (AP), and Kelly's clinical scores (Kelly-Scores), the significant parameters were identified to elucidate the anorectal activity.


RESULTS
(1) A close relationship was observed between the FFP and Kelly-Scores (P = .0027). (2) Flow-max, TR, and AP in patients with good Kelly-Scores were significantly higher than those in patients with fair Kelly-Scores (P < .05). (3) The Flow-max accurately reflected the TR, Kelly-Scores, and AP. Flow-max >45 mL per second, TR >70%, or AP >30 mm Hg was statistically regarded as a borderline level of fecal continence (P < .002).


CONCLUSIONS
The Flow-max and FFP are considered to be useful parameters for postoperative patients with HD.
Yagi
Minoru
M
Department of Pediatric surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata-City, Niigata 951-8510, Japan. yagimi@med.niigata-u.ac.jp
Kubota
Masayuki
M
Kanada
Satoshi
S
Kinoshita
Yoshiaki
Y
Okuyama
Naoki
N
Yamazaki
Satoru
S
Murata
Hiroki
H
Hirayama
Yutaka
Y
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D001696:Biomechanical Phenomena; D002648:Child; D003106:Colon / Q000503:physiopathology / Q000601:surgery; D012809:Colon, Sigmoid / Q000503:physiopathology / Q000601:surgery; D003672:Defecation / Q000502:physiology*; D004733:Enema; D005260:Female; D005500:Follow-Up Studies; D005769:Gastrointestinal Motility; D006627:Hirschsprung Disease / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008365:Manometry; D011184:Postoperative Period; D012007:Rectum / Q000503:physiopathology / Q000601:surgery; D012212:Rheology / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome