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Anorectal manometry after Ikeda's Z-shaped anastomosis in Hirschsprung's disease.
Prog Pediatr Surg. 1989; 24:59-66.PP

Abstract

The intraluminal pressure of the rectum and anal canal were measured in patients with Hirschsprung's disease before and after Ikeda's Z-shaped anastomosis, and the association of the pressure with postoperative capability of fecal continence was assessed. Radical operation did not alter rectal pressure but did decrease anal-canal pressure. Rhythmical anal contractions increased in frequency until a normal level was attained. The rectoanal relaxation reflex became distinct with time, and 45% of patients eventually attained the reflex after operation. In patients who postoperatively attained satisfactory fecal continence or, at least, only soiling, resting pressure in the anorectum and the frequency of rhythmical anal-canal contractions were similar to those for normal children. The rectoanal relaxation reflex was induced in 58% of the former and 27% of the latter. In patients with postoperative constipation, the intraluminal resting pressure of the anorectum was elevated without the relaxation reflex response. In patients with incontinence, the pressure of the anal canal was low, without a reflex response. These findings indicate that the high and low values of the resting pressure of the anal canal are responsible for constipation and incontinence, respectively, and that the presence of rectoanal relaxation reflex may represent one aspect of a normal defecation function.

Authors+Show Affiliations

Department of Surgery, Fukuoka Municipal Children's Hospital, Japan.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

2513614

Citation

Nagasaki, A, et al. "Anorectal Manometry After Ikeda's Z-shaped Anastomosis in Hirschsprung's Disease." Progress in Pediatric Surgery, vol. 24, 1989, pp. 59-66.
Nagasaki A, Sumitomo K, Shono T, et al. Anorectal manometry after Ikeda's Z-shaped anastomosis in Hirschsprung's disease. Prog Pediatr Surg. 1989;24:59-66.
Nagasaki, A., Sumitomo, K., Shono, T., & Ikeda, K. (1989). Anorectal manometry after Ikeda's Z-shaped anastomosis in Hirschsprung's disease. Progress in Pediatric Surgery, 24, 59-66.
Nagasaki A, et al. Anorectal Manometry After Ikeda's Z-shaped Anastomosis in Hirschsprung's Disease. Prog Pediatr Surg. 1989;24:59-66. PubMed PMID: 2513614.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anorectal manometry after Ikeda's Z-shaped anastomosis in Hirschsprung's disease. AU - Nagasaki,A, AU - Sumitomo,K, AU - Shono,T, AU - Ikeda,K, PY - 1989/1/1/pubmed PY - 1989/1/1/medline PY - 1989/1/1/entrez SP - 59 EP - 66 JF - Progress in pediatric surgery JO - Prog Pediatr Surg VL - 24 N2 - The intraluminal pressure of the rectum and anal canal were measured in patients with Hirschsprung's disease before and after Ikeda's Z-shaped anastomosis, and the association of the pressure with postoperative capability of fecal continence was assessed. Radical operation did not alter rectal pressure but did decrease anal-canal pressure. Rhythmical anal contractions increased in frequency until a normal level was attained. The rectoanal relaxation reflex became distinct with time, and 45% of patients eventually attained the reflex after operation. In patients who postoperatively attained satisfactory fecal continence or, at least, only soiling, resting pressure in the anorectum and the frequency of rhythmical anal-canal contractions were similar to those for normal children. The rectoanal relaxation reflex was induced in 58% of the former and 27% of the latter. In patients with postoperative constipation, the intraluminal resting pressure of the anorectum was elevated without the relaxation reflex response. In patients with incontinence, the pressure of the anal canal was low, without a reflex response. These findings indicate that the high and low values of the resting pressure of the anal canal are responsible for constipation and incontinence, respectively, and that the presence of rectoanal relaxation reflex may represent one aspect of a normal defecation function. SN - 0079-6654 UR - https://www.unboundmedicine.com/medline/citation/2513614/Anorectal_manometry_after_Ikeda's_Z_shaped_anastomosis_in_Hirschsprung's_disease_ L2 - https://www.diseaseinfosearch.org/result/3429 DB - PRIME DP - Unbound Medicine ER -