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Long-term manometric study of anal sphincter function after hemorrhoidectomy

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aim

Data on maximum resting pressure (MRP) and maximum squeeze pressure (MSP) changes after hemorrhoidectomy are not univocal and follow-up of patients undergoing surgery is mostly short-lived. The aim of this study was to prospectively examine during 1-year follow-up the long-term manometric results of MRP, MSP, and ultra slow wave activity (USWA) within a set of patients undergoing Milligan–Morgan hemorrhoidectomy as compared to healthy controls.

Materials and methods

Twenty patients with hemorrhoids of third and fourth degree were enrolled and anorectal manometry was performed preoperatively, on the 5th day, and after 1, 6, and 12 months after surgery.

Results

On the 5th and 30th day after hemorrhoidectomy, USWA was slightly increased as compared to preoperative status. Six and 12 months after surgery, patients with USWA were significantly less in comparison to preoperative assessment without differences with healthy subjects. After surgery, MSP values were not significantly different to baseline values. On the 5th postoperative day after hemorrhoidectomy, MRP was significantly greater than baseline preoperative values. Thirty days after surgery, MRP values were similar to those detected preoperatively, but still significantly increased as compared to healthy subjects. After 6 and 12 months, MRP values were significantly lower than those detected during preoperative phase and comparable to healthy subjects.

Conclusions

Our data support that Milligan–Morgan hemorrhoidectomy induces a complete resolution of typical manometric alterations of disease and that the excision of anal cushions is responsible only for mild and transient alteration of anal continence.

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Acknowledgement

This work has been supported by Ministero dell’Università e della Ricerca Scientifica e Tecnologica (MURST), grants 2003–2004.

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Authors and Affiliations

  1. Department of Surgical and Oncological Science, Division of General Surgery, University of Palermo, Palermo, Italy

    Rosalia Patti, Matteo Arcara, Massimiliano Sparacello, Stefania Termine & Sebastiano Bonventre

  2. Department of Gastroenterology, University of Palermo, Palermo, Italy

    Piero Luigi Almasio

  3. Division of General Surgery, University of Palermo, Via Autonomia Siciliana 70, 90143, Palermo, Italy

    Gaetano Di Vita

Authors
  1. Rosalia Patti
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  2. Piero Luigi Almasio
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  3. Matteo Arcara
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  4. Massimiliano Sparacello
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  5. Stefania Termine
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  6. Sebastiano Bonventre
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  7. Gaetano Di Vita
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Correspondence to Gaetano Di Vita.

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Patti, R., Almasio, P.L., Arcara, M. et al. Long-term manometric study of anal sphincter function after hemorrhoidectomy. Int J Colorectal Dis 22, 253–257 (2007). https://doi.org/10.1007/s00384-006-0174-x

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  • DOI: https://doi.org/10.1007/s00384-006-0174-x

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