3D high-resolution anorectal manometry in patients with perianal fistulas: comparison with 3D-anal ultrasound

• DOI: 10.1186/s12876-018-0770-6
• Publication Date: 2018-04-19T10:34:53Z
• Authors: Richelle J. F. Fe...; Maarten S. Vlietstra; Paul F. Vollebregt; Ingrid J. M. Han-...; Vera Rempe-Sorm; Grietje J. H. Van...; Charlotte B. H. M...
• Keywords: Fistulotomy; Endoanal ultrasound; Anorectal manometry; Fecal Incontinence; Perianal Abscess

Perianal fistula surgery can damage the anal sphincters which may cause faecal incontinence. By measuring regional pressures, 3D-HRAM potentially provides better guidance for surgical strategy in patients with perianal fistulas. The aim was to measure pressures and compare these 3D-EUS findings Consecutive active fistulas who underwent both at a clinic specialised proctology were included. A group of 30 without served as controls. Data regarding demographics, complaints, previous procedures obstetric history collected. mean measured 3D-HRAM. Fistula tract areas detected analysed by visual coding corresponding surrounding area measured. study granted VUmc Medical Ethical Committee. Forty (21 males, age 47) Four had primary fistula, 19 previously treated seton/abscess drainage 17 recurrence after performed surgery. On 3D-HRAM, 24 (60%) good 8 (20%) moderately visible. All but 7 (18%) normal resting pressures. pressure significantly lower compared (47 vs. 76 mmHg; p < 0.0001). Only 2 (5%) 10 mmHg area. Using Δ ≥ difference between non-fistula alternative cut-off, 21 (53%) identified. In 6 repeated surgery: local drop one patient fistulotomy increased complaints Profound drops are found Fistulotomy affect sphincter pressure. This might influence decision making future.