Evidence map›Paper›PMID 29618340›Full record

ArticleBMC gastroenterology2018

3D high-resolution anorectal manometry in patients with perianal fistulas: comparison with 3D-anal ultrasound.

Richelle J F Felt-Bersma, Maarten S Vlietstra, Paul F Vollebregt, Ingrid J M Han-Geurts, Vera Rempe-Sorm, Grietje J H Vander Mijnsbrugge, Charlotte B H Molenaar

Open access · goldAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Perianal Fistula; from Etiology to Treatment - A Review.Middle East journal of digestive diseases · 2024
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Richelle J F Felt-BersmaDepartment of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands. rjf.felt@vumc.nl.
Maarten S VlietstraDepartment of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands.
Paul F VollebregtDepartment of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands.
Ingrid J M Han-GeurtsProctos Clinic, Bilthoven, The Netherlands.
Vera Rempe-SormProctos Clinic, Bilthoven, The Netherlands.
Grietje J H Vander MijnsbruggeProctos Clinic, Bilthoven, The Netherlands.
Charlotte B H MolenaarProctos Clinic, Bilthoven, The Netherlands.
Amsterdam UMC Location VUmc · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPerianal fistula surgery can damage the anal sphincters which may cause faecal incontinence. By measuring regional pressures, 3D-HRAM potentially provides better guidance for surgical strategy in patients with perianal fistulas. The aim was to measure regional anal pressures with 3D-HRAM and to compare these with 3D-EUS findings in patients with perianal fistulas.

methodsConsecutive patients with active perianal fistulas who underwent both 3D-EUS and 3D-HRAM at a clinic specialised in proctology were included. A group of 30 patients without fistulas served as controls. Data regarding demographics, complaints, previous perianal surgical procedures and obstetric history were collected. The mean and regional anal pressures were measured with 3D-HRAM. Fistula tract areas detected with 3D-EUS were analysed with 3D-HRAM by visual coding and the regional pressures of the corresponding and surrounding area of the fistula tract areas were measured. The study was granted by the VUmc Medical Ethical Committee.

resultsForty patients (21 males, mean age 47) were included. Four patients had a primary fistula, 19 were previously treated with a seton/abscess drainage and 17 had a recurrence after previously performed fistula surgery. On 3D-HRAM, 24 (60%) fistula tract areas were good and 8 (20%) moderately visible. All but 7 (18%) patients had normal mean resting pressures. The mean resting pressure of the fistula tract area was significantly lower compared to the surrounding area (47 vs. 76 mmHg; p < 0.0001). Only 2 (5%) patients had a regional mean resting pressure < 10 mmHg of the fistula tract area. Using a Δ mean resting pressure ≥ 30 mmHg difference between fistula tract area and non-fistula tract area as alternative cut-off, 21 (53%) patients were identified. In 6 patients 3D-HRAM was repeated after surgery: a local pressure drop was detected in one patient after fistulotomy with increased complaints of faecal incontinence.

conclusionsProfound local anal pressure drops are found in the fistula tract areas in patients normal mean resting pressures. Fistulotomy may affect local sphincter pressure. This might influence surgical decision making in future.

Indexed as

AdultAgedAnal CanalCase-Control StudiesClinical Decision-MakingEndosonographyFemaleHumansImaging, Three-DimensionalMaleManometryMiddle AgedPressureRectal FistulaRetrospective StudiesYoung Adult3D-EUS3D-HRAMAnal fistulaAnorectal manometryEndoanal ultrasound

Identifiers

PMID29618340
PMCPMC5885412
OpenAlexW2796158522

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.