title: Fecoflowmetric profiles in postoperative patients with Hirschsprung's disease.
abstract: 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.
authors.affiliation: 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
authors.forename: Minoru
authors.initials: M
authors.lastname: Yagi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kubota
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kanada
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kinoshita
authors.forename: Naoki
authors.initials: N
authors.lastname: Okuyama
authors.forename: Satoru
authors.initials: S
authors.lastname: Yamazaki
authors.forename: Hiroki
authors.initials: H
authors.lastname: Murata
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hirayama
mesh_terms: 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