Manometric parameters, when measured with the 3‐dimensional high‐definition anorectal manometry probe, poorly predict prolonged balloon expulsion time
| Autor: | D Y Li, Harman Gill, Summit Sawhney, Armaan Pandey, Yasmin Nasser, Matthew Woo, Michelle Buresi, Christopher N. Andrews |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Constipation Manometry Physiology Anal Canal Balloon Dyssynergia 03 medical and health sciences 0302 clinical medicine Pelvic floor dysfunction medicine Humans Defecography Defecation medicine.diagnostic_test Endocrine and Autonomic Systems business.industry Anorectal manometry Rectum Gastroenterology Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology medicine.symptom business Nuclear medicine |
| Zdroj: | Neurogastroenterology & Motility. 34 |
| ISSN: | 1365-2982 1350-1925 |
| Popis: | Background There are little data evaluating the performance of the 3-dimensional high-definition anorectal manometry (3D-HDAM) system in the diagnosis of dyssynergic defecation. Physical properties of the thicker, rigid, 3D-HDAM probe may have implications on the measurements of anorectal pressures. Aim Our aim was to compare 3D-HDAM to balloon expulsion test and magnetic resonance (MR) defecography. Methods Consecutive constipated patients referred for anorectal function testing at the Calgary Gut Motility Centre (Calgary, Canada) between 2014 and 2019 were assessed. All patients underwent anorectal manometry with the 3D-HDAM probe, and a subset underwent BET or MR defecography. Anorectal manometric variables were compared between patients who had normal and abnormal BET. Results Over the study period, 81 patients underwent both 3D-HDAM and BET for symptoms of constipation. 52 patients expelled the balloon within 3 minutes. Patients with abnormal BET had significantly lower rectoanal pressure differential (RAPD) (-61 vs. -31 mmHg for normal BET, p = 0.03) and defecation index (0.29 vs. 0.56, p = 0.03). On logistic regression analysis, RAPD (OR: 0.99, 95% CI: 0.97-0.99, p = 0.03) remained a negative predictor of abnormal BET. On ROC analysis, RAPD had an AUC of 0.65. There was good agreement between dyssynergic patterns on 3D-HDAM and defecographic evidence of dyssynergia (sensitivity 80%, specificity 90%, PLR 9, NLR 0.22, accuracy 85%). Conclusions Manometric parameters, when measured with the 3D-HDAM probe, poorly predict prolonged balloon expulsion time. RAPD remains the best predictor of prolonged balloon expulsion time. The 3D-HDAM probe may not be the ideal tool to diagnose functional defecatory disorders. |
| Databáze: | OpenAIRE |
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