1. Manometric Studies for Evaluation of Ano-Rectal Activity
Quantitative anorectal manometry by open tipped method modified cylinder core was examined on 70 normal subjects ranging birth to adult for the evaluation of physiological anorectal function and also discussed the methodology of pressure studies. At the neonatal period, especially during first week...
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| Published in | Nippon Daicho Komonbyo Gakkai Zasshi Vol. 30; no. 1; pp. 1 - 9,92 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
The Japan Society of Coloproctology
1977
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| Online Access | Get full text |
| ISSN | 0047-1801 1882-9619 |
| DOI | 10.3862/jcoloproctology.30.1 |
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| Abstract | Quantitative anorectal manometry by open tipped method modified cylinder core was examined on 70 normal subjects ranging birth to adult for the evaluation of physiological anorectal function and also discussed the methodology of pressure studies. At the neonatal period, especially during first week of life, anorectal pressure is very low, as well as recto-sphincteric reflex shows inactive. However, greatest rate of growth takes place unti 2 months after birth. The length of anal canal develops markedly in the second decade. From the physiological point of view, we divided functional anal canal into 3 parts, ie, puborectalis zone, internal sphincter zone, external sphincter zone. With introduction of increasing volume of air into the rectal balloon, the internal sphincter zone showed gradual decrease of basal tone and the puborectalis zone a similar reduction of tonic activity. For the assesment of anorectal defecative motility, we advocate to measure the " REFLEX ANORECTAL PRESSURE PROFILE " which composed of projecting the pressure fall on the resting anorectal pressure profile. It demonstrates that the anorectum reduces its tone from upper part to downward with proportional to the increase of rectal pressure. |
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| AbstractList | Quantitative anorectal manometry by open tipped method modified cylinder core was examined on 70 normal subjects ranging birth to adult for the evaluation of physiological anorectal function and also discussed the methodology of pressure studies. At the neonatal period, especially during first week of life, anorectal pressure is very low, as well as recto-sphincteric reflex shows inactive. However, greatest rate of growth takes place unti 2 months after birth. The length of anal canal develops markedly in the second decade. From the physiological point of view, we divided functional anal canal into 3 parts, ie, puborectalis zone, internal sphincter zone, external sphincter zone. With introduction of increasing volume of air into the rectal balloon, the internal sphincter zone showed gradual decrease of basal tone and the puborectalis zone a similar reduction of tonic activity. For the assesment of anorectal defecative motility, we advocate to measure the " REFLEX ANORECTAL PRESSURE PROFILE " which composed of projecting the pressure fall on the resting anorectal pressure profile. It demonstrates that the anorectum reduces its tone from upper part to downward with proportional to the increase of rectal pressure. |
| Author | Miyashita, Y. Morita, K. Hiramoto, Y. Kikuoka, S. Ishihara, M. |
| Author_xml | – sequence: 1 fullname: Miyashita, Y. organization: First Department of Surgery, Nihon University School of Medicine – sequence: 1 fullname: Kikuoka, S. organization: First Department of Surgery, Nihon University School of Medicine – sequence: 1 fullname: Hiramoto, Y. organization: First Department of Surgery, Nihon University School of Medicine – sequence: 1 fullname: Ishihara, M. organization: First Department of Surgery, Nihon University School of Medicine – sequence: 1 fullname: Morita, K. organization: First Department of Surgery, Nihon University School of Medicine |
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| References | 9) Collins, C. D. et al.: Force in the anal canal and continence. Gut, 8 : 354, 1967. 15) Lawson, J. 0. N. & Nixon, H. H.: Anal canal pressures in the diagnosis of Hirsch-sprung's disease. J.P.S., 2 : 544, 1967. 14) Schnaufer, L. et al.: Differential shincteric studies in the diagnosis of ano-rectal disor- ders of childhood. J.P.S., 2 : 538, 1967. 3) Gaston, E. A. : Fecal continence following resections of various portion of rectum with preservation of anal sphincters. S. G. O. 87: 669, 1948. 1) Gower, W. R.: The automatic action of sphinter ani. Proc. Roy. Soc., 26 : 77, 1877. 13) Collaghan, R. P. & Nixon, H. H., Megarectum : Physiological observations. Arch. Dis. Childh., 39 : 153, 1963. 6) Duthie, H. L. & Watts, J. M.: Contribution of the external anal sphincter to pressure zone in the anal canal. Gut. 6 : 64, 1965. 2) Denney-Brown, D. & Robertoson E. G.: An investigation of nervous control of defaecation. Brain, 58 :256, 1935. 11) Hill, J. R. et al.: Pressure profile of the rectum and anus of healthy person, Dis. Colon & Rectum, 3 : 203, 1966. 17) 鈴木宏志: ヒルシユスプルング病の生理学的診断.臨外,26: 1713, 1971. 33) Parks, A. G. et al.: Experimental study of the reflex mechanism controlling the muscle of the pelvic floor. Dis. Colon & Rectum, 2 : 153, 1959. 10) Collins, C. D. et al. : New method of measuring forces in the anal canal. Gut, 10: 160, 1969. 16) 平本靖彦: 先天性巨大結腸症術後における排便機能に関する研究.日大医学誌,26: 883,1967. 27) 宗像敬明,他:新生児の肛門におけるAuer-bach神経叢の構造.日小外会誌,6: 75, 1970. 18) 長崎彰他: 小児外科領域における直腸内圧測定法.小児外科内科,5: 589, 1973. 22) Bennett, R. C. et al.: The physiologic status of the anorectum after pull-through operations. S.G.O., 136 : 907, 1973. 31) Sapiro, S. : Applied anatomy of infants and children in proctology. Rev. Gastroent., 15: 307, 1948. 35) Duthie, H. L. & Gairns, F. W.: Sersory nerve-endings and sensation in the anal region of man. Brit. J. Surg., 47: 585, 1960. 20) 石原通臣,他: 鎖肛術後の排便機能に関する検討.第13回日小外学会発表, 1976. 4) Harris, L. D. et al. : Determination of yield pressures.: A method for meassuring anal sphincter continence. Gastroent., 50 : 754, 1966. 7) Bennett, R. C. & Duthie, H.: The functional importance of the internal anal sphincter. Brit. J.Surg., 51 : 355, 1964. 8) Scharli, A. F. & Kiesewetter, W. B.: Defecation and continence : Some new aspects. Dis. Colon & Rectum, 2 : 81, 1970. 23) 岡本英三,他:排便機能: ヒルシユスプルング病および鎖肛に関連して.外科,34: 365,1972. 25) 渡辺克仁:内肛門括約筋におよぼす粘膜内反射の影響.日平滑筋誌,9: 99, 1973. 36) Rutter, K. R.: The soliary ulcer syndrome of the rectum. Clin. Gastroent., 4:505,1975. 34) Parks, A. G. et al.: The syndrome of the descending perineum. Proc. Roy. Soc. Med. 59: 477, 1966. 12) Porter, N. H.: Megacolon : A physiological study. Proc. Roy. Soc. Med., 54: 1043, 1961. 32) Kerremans, R.: Morphological and physio-logical aspects of anal continince and defaecation. Press Academigues Europeennes S.C.Bruxells,, 1969. 5) Duthie, H. L. & Benett, R. C.: The relation of sensation in the anal canal to func-tional anal sphincter: A possible factor in anal continence. Gut, 4 : 179, 1963. 28) Bass, M. & Schuster, M.: In vitro phar-macologic differentiation of sphincteric and non-sphincteric muscle. Hopkins Med. J., 127: 185, 1970. 29) Parks, A. G. et al.: Prelimiary investiga-tion of the pharmacology of the human internal sphincter. Gut, 10 : 674, 1969. 30) Duthie, H. L.: Dynamics of the rectum and anus. Clin. Gastroent., 4: 467, 1975. 19) Scharli, A. F. & Kiesewetter, W. B.: Imperforate anus: Anorectosigmoidal pressure studies as a quantative evaluation of post-operative continence J.P.S., 4: 694, 1969. 21) Bishop, B. et al.: Control of the external sphincter of the anus in the cat. J. Physiol., 134: 229, 1956. 26) 池田恵一,他:先天性巨大結腸症の術式ならびに手術成績.小児外科内科,1: 243, 1969. 24) Gaston, E. A.: Physiological basis for preservation of fecal continence after resection of rectum. J.A.M.A., 164: 1486, 1951. |
| References_xml | – reference: 12) Porter, N. H.: Megacolon : A physiological study. Proc. Roy. Soc. Med., 54: 1043, 1961. – reference: 18) 長崎彰他: 小児外科領域における直腸内圧測定法.小児外科内科,5: 589, 1973. – reference: 19) Scharli, A. F. & Kiesewetter, W. B.: Imperforate anus: Anorectosigmoidal pressure studies as a quantative evaluation of post-operative continence J.P.S., 4: 694, 1969. – reference: 17) 鈴木宏志: ヒルシユスプルング病の生理学的診断.臨外,26: 1713, 1971. – reference: 35) Duthie, H. L. & Gairns, F. W.: Sersory nerve-endings and sensation in the anal region of man. Brit. J. Surg., 47: 585, 1960. – reference: 2) Denney-Brown, D. & Robertoson E. G.: An investigation of nervous control of defaecation. Brain, 58 :256, 1935. – reference: 16) 平本靖彦: 先天性巨大結腸症術後における排便機能に関する研究.日大医学誌,26: 883,1967. – reference: 21) Bishop, B. et al.: Control of the external sphincter of the anus in the cat. J. Physiol., 134: 229, 1956. – reference: 9) Collins, C. D. et al.: Force in the anal canal and continence. Gut, 8 : 354, 1967. – reference: 25) 渡辺克仁:内肛門括約筋におよぼす粘膜内反射の影響.日平滑筋誌,9: 99, 1973. – reference: 27) 宗像敬明,他:新生児の肛門におけるAuer-bach神経叢の構造.日小外会誌,6: 75, 1970. – reference: 3) Gaston, E. A. : Fecal continence following resections of various portion of rectum with preservation of anal sphincters. S. G. O. 87: 669, 1948. – reference: 11) Hill, J. R. et al.: Pressure profile of the rectum and anus of healthy person, Dis. Colon & Rectum, 3 : 203, 1966. – reference: 4) Harris, L. D. et al. : Determination of yield pressures.: A method for meassuring anal sphincter continence. Gastroent., 50 : 754, 1966. – reference: 6) Duthie, H. L. & Watts, J. M.: Contribution of the external anal sphincter to pressure zone in the anal canal. Gut. 6 : 64, 1965. – reference: 28) Bass, M. & Schuster, M.: In vitro phar-macologic differentiation of sphincteric and non-sphincteric muscle. Hopkins Med. J., 127: 185, 1970. – reference: 5) Duthie, H. L. & Benett, R. C.: The relation of sensation in the anal canal to func-tional anal sphincter: A possible factor in anal continence. Gut, 4 : 179, 1963. – reference: 1) Gower, W. R.: The automatic action of sphinter ani. Proc. Roy. Soc., 26 : 77, 1877. – reference: 14) Schnaufer, L. et al.: Differential shincteric studies in the diagnosis of ano-rectal disor- ders of childhood. J.P.S., 2 : 538, 1967. – reference: 20) 石原通臣,他: 鎖肛術後の排便機能に関する検討.第13回日小外学会発表, 1976. – reference: 33) Parks, A. G. et al.: Experimental study of the reflex mechanism controlling the muscle of the pelvic floor. Dis. Colon & Rectum, 2 : 153, 1959. – reference: 23) 岡本英三,他:排便機能: ヒルシユスプルング病および鎖肛に関連して.外科,34: 365,1972. – reference: 31) Sapiro, S. : Applied anatomy of infants and children in proctology. Rev. Gastroent., 15: 307, 1948. – reference: 7) Bennett, R. C. & Duthie, H.: The functional importance of the internal anal sphincter. Brit. J.Surg., 51 : 355, 1964. – reference: 36) Rutter, K. R.: The soliary ulcer syndrome of the rectum. Clin. Gastroent., 4:505,1975. – reference: 29) Parks, A. G. et al.: Prelimiary investiga-tion of the pharmacology of the human internal sphincter. Gut, 10 : 674, 1969. – reference: 8) Scharli, A. F. & Kiesewetter, W. B.: Defecation and continence : Some new aspects. Dis. Colon & Rectum, 2 : 81, 1970. – reference: 32) Kerremans, R.: Morphological and physio-logical aspects of anal continince and defaecation. Press Academigues Europeennes S.C.Bruxells,, 1969. – reference: 34) Parks, A. G. et al.: The syndrome of the descending perineum. Proc. Roy. Soc. Med. 59: 477, 1966. – reference: 15) Lawson, J. 0. N. & Nixon, H. H.: Anal canal pressures in the diagnosis of Hirsch-sprung's disease. J.P.S., 2 : 544, 1967. – reference: 13) Collaghan, R. P. & Nixon, H. H., Megarectum : Physiological observations. Arch. Dis. Childh., 39 : 153, 1963. – reference: 30) Duthie, H. L.: Dynamics of the rectum and anus. Clin. Gastroent., 4: 467, 1975. – reference: 10) Collins, C. D. et al. : New method of measuring forces in the anal canal. Gut, 10: 160, 1969. – reference: 26) 池田恵一,他:先天性巨大結腸症の術式ならびに手術成績.小児外科内科,1: 243, 1969. – reference: 22) Bennett, R. C. et al.: The physiologic status of the anorectum after pull-through operations. S.G.O., 136 : 907, 1973. – reference: 24) Gaston, E. A.: Physiological basis for preservation of fecal continence after resection of rectum. J.A.M.A., 164: 1486, 1951. |
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| Title | 1. Manometric Studies for Evaluation of Ano-Rectal Activity |
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