title: Evaluation of rectal sensory and motor function by means of the electronic barostat after stapled hemorrhoidopexy.
abstract: OBJECTIVE
  Stapled hemorrhoidopexy is designed to replace the hemorrhoids into the anal canal by excising the redundant rectal mucosa above the anorectal ring, thus resulting in an intrarectal suture. Few studies have evaluated rectal function after this procedure. This prospective study was designed to use the electronic barostat to assess whether rectal motor and sensory functions change after stapled hemorrhoidopexy.
  
  
  METHODS
  Ten patients (4 women, mean age, 46 +/- 9 years) with third-degree and fourth-degree hemorrhoids who underwent stapled hemorrhoidopexy were studied. One week before and six months after surgery, they underwent three different rectal distensions (pressure-controlled stepwise, volume-controlled stepwise, and ramp) controlled by an electronic barostat.
  
  
  RESULTS
  Rectal distensibility was significantly lower after surgery during pressure stepwise (P = 0.01), during volume stepwise (P = 0.006), and during ramp distension (P = 0.001). Volume thresholds for desire to defecate, urgency, and discomfort were significantly lower after surgery during all three distensions (P < 0.05). Volume threshold for first perception also was significantly lower after surgery during volume ramp distension (P = 0.01).
  
  
  CONCLUSIONS
  Rectal distensibility and volume thresholds for sensations decrease after stapled hemorrhoidopexy. These impairments persist for at least six months after surgery.
authors.affiliation: Surgical Department, San Raffaele Scientific Institute, Vita-Salute University San Raffaele, Milan, Italy. denardi.paola@hsr.it
authors.forename: Paola
authors.initials: P
authors.lastname: De Nardi
authors.forename: Maura
authors.initials: M
authors.lastname: Corsetti
authors.forename: Sandro
authors.initials: S
authors.lastname: Passaretti
authors.forename: Simone
authors.initials: S
authors.lastname: Squillante
authors.forename: Antonio Gianluca
authors.initials: AG
authors.lastname: Castellaneta
authors.forename: Carlo
authors.initials: C
authors.lastname: Staudacher
authors.forename: Pier Alberto
authors.initials: PA
authors.lastname: Testoni
mesh_terms: D016009:Chi-Square Distribution; D005260:Female; D006484:Hemorrhoids / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D012007:Rectum / Q000503:physiopathology* / Q000601:surgery*; D018709:Statistics, Nonparametric; D017792:Surgical Stapling