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Affiliation
1 Department of Pediatric Surgery, Beijing Children's Hospital, China.
L Li et al. Dis Colon Rectum. 1996 Nov.
Affiliation
1 Department of Pediatric Surgery, Beijing Children's Hospital, China.
Purpose: This study was undertaken to investigate the effects of anal stretching on anal pressures and damage to the external anal sphincter.
Methods: This study was performed on 37 guinea pigs. Animals were divided into three groups: control group, quick stretching group, and continuous overstretching group. Anal stretching was conducted by an 8-F Foley catheter balloon.
Results: It was found that if the muscle was stretched from 100 to 300 percent of its original length, anal resting pressure (ARP) kept relatively steady, but anal contracting pressure (ACP) gradually increased; from 300 to 370 percent, a sharp ARP increase was developed, but ACP gradually decreased to zero; beyond 370 percent, ARP remained unchanged (plateau phase). By histologic examination, it was revealed that when the muscle was stretched at the ARP plateau phase, an ischemic zone of necrosis and an edematous zone of necrosis could be clearly identified in the muscle.
Conclusion: This study shows that length of the external anal sphincter definitively influences muscle strengths, and severe anal stretching will result in muscle damage. These results imply that the sphincteric muscle complex in high or intermediate anorectal anomalies may be injured during present conventional surgical approaches.
Li L, Zhang J, Lu G. Li L, et al. Zhonghua Wai Ke Za Zhi. 1995 Feb;33(2):123-6. Zhonghua Wai Ke Za Zhi. 1995. PMID: 7656702 Chinese.
Culver PJ, Rattan S. Culver PJ, et al. Am J Physiol. 1986 Dec;251(6 Pt 1):G765-71. doi: 10.1152/ajpgi.1986.251.6.G765. Am J Physiol. 1986. PMID: 3789143
Yoo SY, Bae KS, Kang SJ, Kim SY, Hwang EH. Yoo SY, et al. J Pediatr Surg. 1995 May;30(5):687-91. doi: 10.1016/0022-3468(95)90691-6. J Pediatr Surg. 1995. PMID: 7623229
Rasmussen OØ. Rasmussen OØ. Dan Med Bull. 2003 Aug;50(3):262-82. Dan Med Bull. 2003. PMID: 13677243 Review.
Rattan S. Rattan S. Neurogastroenterol Motil. 2005 Jun;17 Suppl 1:50-9. doi: 10.1111/j.1365-2982.2005.00659.x. Neurogastroenterol Motil. 2005. PMID: 15836455 Review.
Li L, Ren X, Ming A, Xu H, Sun R, Zhou Y, Liu X, Sun H, Li Q, Li X, Zhang Z, Cheng W, Diao M, Tam PKH. Li L, et al. Pediatr Surg Int. 2020 Mar;36(3):279-287. doi: 10.1007/s00383-019-04614-x. Epub 2020 Jan 9. Pediatr Surg Int. 2020. PMID: 31919580
Liu XY, Li HT, Li L, Chen L, Wang LJ, Ma K, Zhao BB, Hou XH. Liu XY, et al. Pediatr Surg Int. 2012 Aug;28(8):835-40. doi: 10.1007/s00383-012-3114-6. Epub 2012 Jul 21. Pediatr Surg Int. 2012. PMID: 22820832
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