Search results for "Sphincter"
showing 10 items of 115 documents
Fisurectomy and anoplasty with botulinum toxin injection in patients with chronic anal posterior fissure with hypertonia: a long-term evaluation.
2020
AbstractChronic anal fissure’s (CAF) etiopathogenesis remain unclear. CAF of the posterior commissure (CAPF) are often characterized by internal anal sphincter (IAS) hypertonia. The treatment of this disease aimed to reduce IAS hypertonia. Due to the high rate of anal incontinence after LIS, the employment of sphincter preserving surgical techniques associated to pharmacological sphincterotomy appears more sensible. The aim of our study is to evaluate the long-term results of fissurectomy and anoplasty with V–Y cutaneous flap advancement associated to 30 UI of botulinum toxin injection for CAPF with IAS hypertonia. We enrolled 45 patients undergone to fissurectomy and anoplasty with V–Y cut…
Gastroesophageal Reflux and Bleeding Esophageal Varices
1979
The incidence of gastroesophageal reflux was evaluated with the use of a pH probe in 12 patients with cirrhosis and recent variceal hemorrhage and in 15 healthy control subjects. Short episodes of reflux occurred in 42% of the patients and in 47% of the controls. During an observation period of 1 hr, the cumulative duration of reflux was similar in patients (2.5 ± 1.3 min) and controls (3.1 ± 1.4 min). Mean lower esophageal sphincter pressures were normal in both groups but did not show a significant correlation with the duration of reflux. These data support previous observations that gastroesophageal reflux does not appear to be a contributing factor in the development of variceal hemorrh…
Management of rectal cancer in France in a well-defined population.
2014
Objective The aim of this study was to draw a picture of diagnostic assessment and patterns of care for rectal cancer in France using population-based registries data. Methods The study included a random sample of 669 cases of rectal cancers diagnosed in 2005. Results Diagnostic assessment was performed by colonoscopy in 91.4% of the cases. An abdominal computed tomography was performed in 59.4% of the cases and chest computed tomography in 47.8%. An R0 resection was performed in 65.8% of cases and an R1/R2 resection in 16.1%. A rectal endosocography was performed in 40.4% and MRI in 10.4%. The sphincter was preserved in 73.6% of patients aged younger than 75 years of age and in 62.5% of th…
Opioid-induced Lower Esophageal Sphincter Dysfunction
2015
The adverse gastrointestinal effects of opioids have been extensively described in medical literature.1 Their effect takes place mainly on the enteric nervous system, through receptors in the myenteric and submucosal plexuses. There are 3 recognized main opium receptors (μ, δ, and κ) that are expressed in the central and enteric nervous systems, which mediate the gastrointestinal effects.2 The mainly studied adverse gastrointestinal effect of opioids is constipation, due to the greater understanding of opium receptor physiology in the colon.3 However their effect on esophageal motility has seldom been studied. Our study’s objective was to assess esophageal motility, using high-resolution ma…
Different muscarine receptors mediate the prejunctional inhibition of [3H]-noradrenaline release in rat or guinea-pig iris and the contraction of the…
1989
To investigate the muscarine receptor type mediating inhibition of [3H]-noradrenaline release from the isolated rat and guinea-pig iris we have determined the potency of antimuscarinic drugs to antagonize the methacholine-induced inhibition of [3H]-noradrenaline overflow evoked by field stimulation (3 Hz, 2 min). The prejunctional apparent affinities were compared with those obtained for postjunctional muscarine receptors mediating the methacholine-induced contraction of the isolated rabbit iris sphincter muscle. Prejunctional apparent affinity constants of pirenzepine (6.67), himbacine (8.51), methoctramine (7.92), 4-diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP, 8.00), hexahydro-d…
Performing, Analyzing, and Interpreting HRAM and HDAM Recordings
2020
Anorectal manometry is one of the most widely performed tests for the assessment of anal sphincter function and anorectal coordination. Nowadays high resolution (HRAM) and high definition anorectal manometry (HDAM) are available, instead of the water-perfused system. The ability to visualize the anorectum as a dynamic structure during test maneuvers should intuitively allow for a better appreciation of the normal physiology and hopefully enhance our understanding of the pathophysiology of defecatory dysfunctions. Even if the anorectal manometry protocols can vary by centers, the procedure must include an assessment of rectoanal pressure and anal canal length at rest, cough reflex test, rect…
Sphincter damage during fistulotomy for perianal fistulae and its relationship with faecal incontinence.
2021
Abstract Background The length of sphincter which can be divided during fistulotomy for perianal fistula is unclear. The aim was to quantify sphincter damage during fistulotomy and determine the relationship between such damage with symptoms and severity of faecal incontinence and long-term quality of life (QOL). Methods A prospective cohort study was performed over a 2-year period. Patients with intersphincteric and mid to low transsphincteric perianal fistulas without risk factors for faecal incontinence were scheduled for fistulotomy. All patients underwent 3D endoanal ultrasound (3D-EAUS) pre-operatively and 8 weeks postoperatively. Measurements were taken of pre- and postoperative anal…
Intraoperative cholangiography during cholecystectomy using a biliary-nose tube: Routinely used in patients with main bile duct stones
2021
Background: Nowadays, the “gold standard” treatment for gallbladder stones is laparoscopic cholecystectomy but the risk of iatrogenic biliary duct injuries is increased compared to “open” surgery. Intraoperative cholangiography (IOC) can be useful to avoid biliary injuries but it can also be a no-safe procedure in center in which it is not routinely performed. Aim and objective: The aim of our study is to trust the efficacy of IOC in a patient with common bile duct (CBD) and gallbladder stones using a biliary-nose tube. Materials and methods: 135 patients with gallbladder and CBD stones were treated with sequential therapy and randomly divided into two groups. Laparoscopic cholecystectomy w…
Is intraoperative neuromonitoring associated with better functional outcome in patients undergoing open TME?
2013
Aims: Intraoperative neuromonitoring (IONM) aims to control nerve-sparing total mesorectal excision (TME) for rectal cancer in order to improve patients’ functional outcome. This study was designed to compare the urogenital and anorectal functional outcome of TME with and without IONM of innervation to the bladder and the internal anal sphincter. Methods: A consecutive series of 150 patients with primary rectal cancer were analysed. Fifteen match pairs with open TME and combined urogenital and anorectal functional assessment at follow up were established identical regarding gender, tumour site, tumour stage, neoadjuvant radiotherapy and type of surgery. Urogenital and anorectal function was…
Functional gastrointestinal disorders: Dynamic observation of pediatric cases
2015
Introduction: Functional gastrointestinal disorders (FGID) are a variable set of clinical cases characterized by recurrent/chronic symptoms not associated with an organic pathology. These disorders are classified using the Rome III criteria. Objective: The study wanted to evaluate the prevalence by gender and age of FGIDs in a pediatric population recruited on the basis of recurrent/chronic abdominal pain, and to follow up patients for six months by administering questionnaires aimed at verifying any changes in symptoms. We also evaluated the possible involvement of factors responsible for these changes. Results: 62 patients between 4 and 17 years of age (27 males and 35 females) were inclu…