P J Morgado1, S D Wexner, J M Jorge. 1. Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale 33309.
Abstract
PURPOSE: Maximum resting and squeeze pressures have been the most widely employed parameters for manometric assessment of the anal sphincters. However, a single maximum value may not always be the best assessment. METHODS: The aim of this study was to compare mean and maximum resting and mean and maximum squeeze pressures in a large sample population. All manometric pressure profiles were reviewed by a single individual blinded to the patient's age and diagnosis. RESULTS: Four hundred sixty-six patients with a measurable high-pressure zone were included in this study. The study population was comprised of 279 females and 186 males. A significant difference was found between mean (56.26 mmHg) and maximum (79.2 mmHg) resting pressures (P < 0.01) and also between mean (81.25 mmHg) and maximum (119.50 mmHg) squeeze pressures (P < 0.01). A significant difference (P < 0.01) was also observed when compared by length of the high-pressure zone. CONCLUSION: The measurement, documentation, and reporting of mean resting and mean squeeze pressures provide a better perspective of anal manometric results, since the two sets of values are significantly different (P < 0.01), regardless of the anal canal length. Therefore, these data support the standardized evaluation of both mean and maximum pressures in individual patients and in published series.
PURPOSE: Maximum resting and squeeze pressures have been the most widely employed parameters for manometric assessment of the anal sphincters. However, a single maximum value may not always be the best assessment. METHODS: The aim of this study was to compare mean and maximum resting and mean and maximum squeeze pressures in a large sample population. All manometric pressure profiles were reviewed by a single individual blinded to the patient's age and diagnosis. RESULTS: Four hundred sixty-six patients with a measurable high-pressure zone were included in this study. The study population was comprised of 279 females and 186 males. A significant difference was found between mean (56.26 mmHg) and maximum (79.2 mmHg) resting pressures (P < 0.01) and also between mean (81.25 mmHg) and maximum (119.50 mmHg) squeeze pressures (P < 0.01). A significant difference (P < 0.01) was also observed when compared by length of the high-pressure zone. CONCLUSION: The measurement, documentation, and reporting of mean resting and mean squeeze pressures provide a better perspective of anal manometric results, since the two sets of values are significantly different (P < 0.01), regardless of the anal canal length. Therefore, these data support the standardized evaluation of both mean and maximum pressures in individual patients and in published series.
Authors: Rodrigo Ambar Pinto; Isaac José Felippe Correa-Neto; Leonardo Alfonso Bustamante-Lopez; Caio Sergio R Nahas; Carlos Frederico S Marques; Carlos Walter Sobrado-Junior; Ivan Cecconello; Sergio Carlos Nahas Journal: Arq Bras Cir Dig Date: 2021-06-11