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Rectal intussusception: can high resolution three-dimensional ano-rectal manometry compete with conventional
A Benezech1,2, M Cappiello3, K Baumstarck4
1Service de Gastroentérologie, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
Neurogastroenterology and Motility
|November 29, 2016
Summary
Three-dimensional high-resolution anorectal manometry (3DHRAM) can diagnose rectal intussusceptions (RI) by identifying anterior high-pressure areas and excessive perineal descent. This diagnostic strategy shows high accuracy for RI detection in patients with anorectal disorders.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Pelvic Floor Disorders
Background:
- Three-dimensional high-resolution anorectal manometry (3DHRAM) is a novel technique for evaluating anorectal disorders.
- It provides topographic data useful for diagnosing pelvic floor disorders, including excessive perineal descent.
Purpose of the Study:
- To establish a diagnostic strategy using 3DHRAM parameters for identifying rectal intussusceptions (RI).
- To compare the diagnostic performance of 3DHRAM against conventional defecography (CD) as the gold standard.
Main Methods:
- Patients undergoing 3DHRAM for fecal incontinence or constipation with prior CD were included.
- 3DHRAM parameters were analyzed, focusing on high-pressure zones during attempted defecation.
- Sensitivity, specificity, and predictive values were calculated for various 3DHRAM criteria.
Main Results:
- Rectal intussusceptions (RI) were present in 66% of patients on CD.
- The combination of an anterior high-pressure area and excessive perineal descent on 3DHRAM demonstrated 100% positive predictive value and 100% specificity for RI.
- The sensitivity for RI detection using this 3DHRAM strategy was 69.2%.
Conclusions:
- 3DHRAM is a valuable tool for diagnosing RI and other pelvic floor disorders.
- The proposed 3DHRAM diagnostic strategy shows high accuracy for RI detection.
- Further research is needed to classify new anatomical data obtained from 3DHRAM.