The influence of neurogenic anorectum to the function of anorectum / 中国现代普通外科进展

ABSTRACT

Objective:To study the influence of neurogenic anorectum induced by myelodysplasia on function of anorectum.Methods:Twenty-five patients with myelodysplasia were evaluated by anorectal manometry.The function of anal sphincter was evaluated by resting pressure,contractive pressure and the length of high pressure;The sensation of rectum was evaluated by rectal maximum volume threshold;The function of defecation reflex was evaluated by rectoanal inhibitory reflex.Results:Anal resting pressure in the children with neurogenic anorectum induced by myelodysplasia( 25.8?3.4)mmHg was lower than that in normal children(66.7?24)mmHg.The maximum contractive pressure of anus in patients (86.6?20.1)mmHg was lower than that in normal children(129.0?18.8)mmHg.The length of high pressure in patients (17.5?4.5)mm was lower than that in normal children(23.6?4.6)mm.The rectal volume at sensory threshold in patients(62.1?8.5)ml was higher than that in normal children(36.0?12.6)ml.Rectal maximum volume threshold in patients(141.4?22.6)ml was higher than that in normal children (109.5?12.2)ml.Rectoanal inhibitory reflex was identified in both patients and normal children.Conclusions:Anorectal manometry may provide objective assessment of the neurogenic damage of anorectum in myelodysplasia including the damage of sphincter and the decrease of the rectal sensation. Rectoanal inhibitory reflex was identified in both patients and normal children. The major objective of anorectal treatment for patients with myelodysplasia was to strengthen the function of external sphincter, internal sphincter and pelvis floor muscle and to repair the sensation of rectum.