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직장항문질환에서 내압검사의 유용성

Usefulness of Manometry in Anorectal Diseases

대한대장항문학회지 2000년 16권 6호 p.376 ~ 382
김창남 ( Kim Chang-Nam ) - 을지대학교 의과대학 외과학교실

박상규 ( Park Sang-Kyu ) - 울산대학교 의과대학 외과학교실
김숙영 ( Kim Suk-Young ) - 울산대학교 의과대학 외과학교실
유창식 ( Yu Chang-Sik ) - 울산대학교 의과대학 외과학교실
김진천 ( Kim Jin-Cheon ) - 울산대학교 의과대학 외과학교실

Abstract


Purpose: Anorectal manometry is an objective means of assessing the anorectal function through the anorectal sphincter muscles. The purpose of this study was to assess the usefulness of anorectal manometry.

Methods: Manometric findings of 1145 patients with anorectal diseases were analyzed.

Results: In hemorrhoids, the maximum resting pressure (MRP) was significantly decreased postoperatively (P<0.05), and the maximum squeezing pressure (MSP) was decreased postoperatively. The MRP was increasedin hemorrhoids, internal sphincter hypertonia, and chronic anal fissure (CAF). The MRP and MSP were significantly decreased in CAF, anal fistula, and anal stricture postoperatively (P<0.05). In anal fistula, the high pressure zone length and sphincter length were significantly decreased postoperatively (P<0.05), and the vector symmetric index was decreased to 0.79 postoperatively. Fourteen of the 57 patients with fecal incontinence did not show rectoanal inhibitory reflex (RAIR). In 22 of the 25 patients were clinically suspected of congenital megacolon (CMC), unnecessary surgery was avoided with RAIR. Twelve of the 15 patients with CMC, who had undergone surgery, showed the RAIR. In patients treated by total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) and familial adenomatous polyposis (FAP), the MRP and MSP were decreased postoperatively, and the sensation of fullness (SOF) was significantly decreased postoperatively (P<0.05). In patients with rectal cancer treated by low anterior resection, the MRP, MSP, SOF, and compliance were significantly decreased until 12 months postoperatively (P<0.05).

Conclusion: Manometry appears to be an important tool to evaluate anorectal function that enables adequate surgery or treatment for the most of anorectal diseases. Furthermore, it is a valuable tool in assessing functional recovery after surgeries associated with a sphincter injury.

키워드

항문;직장;질환;내압검사
Anus;Rectum;Disease;Manometry
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