Objective: To evaluate rectal sensitivity in patients with pediatric constipat ion (PC) and nonretentive fecal soiling (FNRFS) using pressure-controlled diste ntion (barostat). Study design: Thresholds for rectal sens...Objective: To evaluate rectal sensitivity in patients with pediatric constipat ion (PC) and nonretentive fecal soiling (FNRFS) using pressure-controlled diste ntion (barostat). Study design: Thresholds for rectal sensitivity (first sensati on, urge to defecate, and pain), and rectal compliance were determined using a b arostat. Results: A total of 69 patients with PC (50 males; mean age, 10.9±2.2 years) and 19 patients with FNRFS (15 males; mean age, 10.0±1.9 years) were com pared with 22 healthy volunteers (HVs) (11 males; mean age, 12.7±2.6 years). Se nsitivity thresholds were not significantly different among the 3 groups. Rectal compliance was increased in 58%of the patients with PC (P < .0001 vs HVs). Rectal compliance did not differ between patients with FNRFS and HVs. Children with PC with abnormal rectal function required significantly larger rectal volumes a t urge to defecate. Conclusions: Increased compliance is the most prominent feat ure in patients with PC. Because of higher compliance in these children, larger stool volumes are required to reach the intrarectal pressure of the urge to defe cate. Children with FNRFS have normal rectal function.展开更多
AIM: To assess the extent and reasons of non- compliance in surveillance for patients undergoing polypectomy of large (≥ 1 cm) colorectal adenomas. METHODS: Between 1995 and 2002, colorectal adenomas ≥ 1 cm were dia...AIM: To assess the extent and reasons of non- compliance in surveillance for patients undergoing polypectomy of large (≥ 1 cm) colorectal adenomas. METHODS: Between 1995 and 2002, colorectal adenomas ≥ 1 cm were diagnosed in 210 patients and subsequently documented at the Erlangen Registry of Colorectal Polyps. One hundred and fi fty-eight patients (75.2%) could be contacted by telephone and agreed to be interviewed. Additionally, records were obtained from the treating physicians. RESULTS: Fifty-four out of 158 patients (34.2%) neglected any surveillance. Reasons for non-compliance included lack of knowledge concerning surveillance intervals (45.8%), no symptoms (29.2%), fear of examination (18.8%) or old age/severe illness (6.3%). In a multivariate analysis, the factors including female gender (P = 0.036) and age > 62 years (P = 0.016) proved to be signif icantly associated with non-compliance in surveillance. CONCLUSION: Efforts to increase compliance in surveillance are of utmost importance. This applies particularly to women’s compliance. Effective strategies for avoiding metachronous colorectal adenoma and cancer should focus on both the improvement in awareness and knowledge of patients and information about physicians for surveillance.展开更多
目前，吻合器痔上黏膜环切钉合术（procedure for prolapse and hemorrhoids，PPH）由于其良好的疗效以及手术时间短、疼痛程度轻和恢复快等优点而得到了广泛应用。然而，随着PPH的广泛使用，关于PPH相关的严重并发症的报道也越来越多...目前，吻合器痔上黏膜环切钉合术（procedure for prolapse and hemorrhoids，PPH）由于其良好的疗效以及手术时间短、疼痛程度轻和恢复快等优点而得到了广泛应用。然而，随着PPH的广泛使用，关于PPH相关的严重并发症的报道也越来越多，其中包括吻合口狭窄、排粪障碍以及直肠阴道瘘等。据统计，PPH术后发生吻合口狭窄的发生率高达22％。进一步研究发现，PPH术后部分出现排粪困难的患者并没有出现吻合口狭窄，其发生可能与直肠顺应性降低相关。因此，PPH可能由于环状切除的特性导致一些传统痔切除术所没有的一些并发症。此外，临床上绝大多数的脱垂性痔病并不是环状脱垂，而更多地表现为孤立痔核的脱垂。最常见的孤立痔核脱垂部位是截石位的3、7、11点。展开更多
文摘Objective: To evaluate rectal sensitivity in patients with pediatric constipat ion (PC) and nonretentive fecal soiling (FNRFS) using pressure-controlled diste ntion (barostat). Study design: Thresholds for rectal sensitivity (first sensati on, urge to defecate, and pain), and rectal compliance were determined using a b arostat. Results: A total of 69 patients with PC (50 males; mean age, 10.9±2.2 years) and 19 patients with FNRFS (15 males; mean age, 10.0±1.9 years) were com pared with 22 healthy volunteers (HVs) (11 males; mean age, 12.7±2.6 years). Se nsitivity thresholds were not significantly different among the 3 groups. Rectal compliance was increased in 58%of the patients with PC (P < .0001 vs HVs). Rectal compliance did not differ between patients with FNRFS and HVs. Children with PC with abnormal rectal function required significantly larger rectal volumes a t urge to defecate. Conclusions: Increased compliance is the most prominent feat ure in patients with PC. Because of higher compliance in these children, larger stool volumes are required to reach the intrarectal pressure of the urge to defe cate. Children with FNRFS have normal rectal function.
基金Supported by a grant from the ELAN-Program of the FAUErlangen, Germany, No. 00.05.31.1
文摘AIM: To assess the extent and reasons of non- compliance in surveillance for patients undergoing polypectomy of large (≥ 1 cm) colorectal adenomas. METHODS: Between 1995 and 2002, colorectal adenomas ≥ 1 cm were diagnosed in 210 patients and subsequently documented at the Erlangen Registry of Colorectal Polyps. One hundred and fi fty-eight patients (75.2%) could be contacted by telephone and agreed to be interviewed. Additionally, records were obtained from the treating physicians. RESULTS: Fifty-four out of 158 patients (34.2%) neglected any surveillance. Reasons for non-compliance included lack of knowledge concerning surveillance intervals (45.8%), no symptoms (29.2%), fear of examination (18.8%) or old age/severe illness (6.3%). In a multivariate analysis, the factors including female gender (P = 0.036) and age > 62 years (P = 0.016) proved to be signif icantly associated with non-compliance in surveillance. CONCLUSION: Efforts to increase compliance in surveillance are of utmost importance. This applies particularly to women’s compliance. Effective strategies for avoiding metachronous colorectal adenoma and cancer should focus on both the improvement in awareness and knowledge of patients and information about physicians for surveillance.
文摘目前，吻合器痔上黏膜环切钉合术（procedure for prolapse and hemorrhoids，PPH）由于其良好的疗效以及手术时间短、疼痛程度轻和恢复快等优点而得到了广泛应用。然而，随着PPH的广泛使用，关于PPH相关的严重并发症的报道也越来越多，其中包括吻合口狭窄、排粪障碍以及直肠阴道瘘等。据统计，PPH术后发生吻合口狭窄的发生率高达22％。进一步研究发现，PPH术后部分出现排粪困难的患者并没有出现吻合口狭窄，其发生可能与直肠顺应性降低相关。因此，PPH可能由于环状切除的特性导致一些传统痔切除术所没有的一些并发症。此外，临床上绝大多数的脱垂性痔病并不是环状脱垂，而更多地表现为孤立痔核的脱垂。最常见的孤立痔核脱垂部位是截石位的3、7、11点。
