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Introducing Anorectal Physiology Lab
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H. Matsuoka1,
T. Masaki1,
M. Sugiyama1 |
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1Department of Surgery, Kyorin University |
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| There has been a renascent interest in physiologic evaluation of the gastrointestinal tract. Anorectal physiologic examinations promote not only as research tool but also for application to the patient in a therapeutic settings. Anorectal manometry is the primary examination to represent anal canal pressure. In combination with balloon equipment, sensory threshold of the inflation and maximal tolerable volume, and rectoanal inhibitory reflex (RAIR) were measured. Anal endosonography represents the morphologic imaging of the anorectum. It is applied to anal sphincter component injury (e.g. pelvic surgery or obstetric trauma). Nerve conduction study (i.e. pudendal nerve terminal motor latency: PNTML) is for neruomuscluar dysfunction, whether secondary to disorder of the nervous system. Defecography is to represent actual bowel movement on radiography. Also videoproctography is much more important than static defecography to objectify their serial bowel movement. It supports to project objective functional movement. Bowel transit study is to objectify postoperative bowel movement by intaking radio-opaque markers. Patients' subjective responds are quite important. To objectify subjective patient respond, also along with these objective anorectal physiologic investigations. It could be also objectified by scores. The presence of fecal incontinence and its degree are represented by fecal incontinence score such as Wexner score, Kirwan score and more. LARS score (Low anterior resection syndrome) poised not only incontinence tendency but also constipated condition to objectify the degree of these postoperative evacuatory disorder following the anal sphincter saving operation. |
Index Term 1: anorectal physiology
Index Term 2: Intersphincteric resection |
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