Purpose: Pneumatic balloon dilation has been shown to be effective in the management of chronic anal fissure, but its effect on the anal sphincter has not been fully investigated. The aim of this study was to evaluate prospectively the clinical, anatomic, and functional pattern in a group of patients treated by pneumatic balloon dilation.
Methods: A series of 33 consecutive patients suffering from chronic anal fissure underwent pneumatic balloon dilation. Anal manometry and ultrasonography were performed prior to and 6 to 12 months after the treatment. Manometry was accomplished by means of an endoanal 40-mm balloon inflated with a pressure of 1.4 atmospheres that was left in situ for six minutes under local anesthesia. All patients were interviewed daily for three days after surgery and then clinically evaluated between the third and fifth postoperative weeks. Most patients were interviewed after 25.7 +/- 8.4 months (mean +/- standard deviation). Anal incontinence was evaluated by means of a validated score of 1 to 6.
Results: The chronic anal fissure healed between the third and fifth weeks in 31 patients (94 percent), who became asymptomatic 2.5 +/- 1.4 days after pneumatic balloon dilation. None of them reported anal pain two years after the treatment (n = 20). The first post-pneumatic balloon dilation defecation was painless in 27 cases (82 percent). Two multiparous females (6 percent of the patients) complained of minor transient anal incontinence (score, 3). Chronic anal fissure recurred in one case (3 percent) after treatment. At manometry, the preoperative anal resting pressure decreased from 91 +/- 11.2 to 70.5 +/- 5.6 and to 78 +/- 5.7 mmHg, 6 and 12 months after pneumatic balloon dilation, respectively (P < 0.0001). Anal ultrasonography did not show any significant sphincter defect.
Conclusions: Pneumatic balloon dilation seems to be an effective, safe, easy procedure that decreases anal resting pressure without endosonographically detectable significant sphincter damage.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s10350-004-0780-z | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A comparison on safety and efficacy between 24 Fr versus 18 Fr pneumatic balloon dilators for percutaneous treatment of renal stones between 10 and 20 mm: results from a contemporary cohort.
World J Urol
January 2025
Department of Urology, Azienda Socio Sanitaria Territoriale Lariana, Como, Italy.
Purpose: To assess differences in safety and efficacy between 24 and 18 Fr pneumatic balloon dilators for percutaneous nephrolithotripsy (PCNL) of renal stones between 10 and 20 mm.
Methods: Patients were randomized to dilatation with a 24 Fr (Group A) versus 18 Fr (Group B) Ultraxx pneumatic dilator (Cook Medical). In all procedures percutaneous puncture was performed under ultrasound guidance.
Human Applications of the Anstadt Cup: Implications for Non-Blood-Contacting Biventricular Support.
Ann Thorac Surg Short Rep
December 2024
Duke University Medical Center, Durham, North Carolina.
Background: Direct mechanical ventricular actuation (DMVA) with the Anstadt cup is effective for non-blood-contacting biventricular support. Pneumatic regulation of a silicone device augments ventricular pump function. Vacuum attachment facilitates diastolic augmentation critical for biventricular support.
View Article and Find Full Text PDFDevelopment of a Self-Deploying Extra-Aortic Compression Device for Medium-Term Hemodynamic Stabilization: A Feasibility Study.
Adv Sci (Weinh)
December 2024
Graduate School of Biomedical Engineering, Faculty of Engineering, and Tyree Institute of Health Engineering (IHealthE), UNSW Sydney, Kensington Campus, Sydney, NSW, 2052, Australia.
Hemodynamic stabilization is crucial in managing acute cardiac events, where compromised blood flow can lead to severe complications and increased mortality. Conditions like decompensated heart failure (HF) and cardiogenic shock require rapid and effective hemodynamic support. Current mechanical assistive devices, such as intra-aortic balloon pumps (IABP) and extracorporeal membrane oxygenation (ECMO), offer temporary stabilization but are limited to short-term use due to risks associated with prolonged blood contact.
View Article and Find Full Text PDFA less-invasive left atrial assist device concept for diastolic heart failure: First in vitro and in vivo assessment.
JTCVS Open
October 2024
Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.
Objective: A less-invasive left atrial assist device (LAADx) is a novel and implantable, extracardiac blood pump concept, intended for the treatment of diastolic heart failure, represented by heart failure with preserved ejection fraction.
Methods: A mixed-flow pump was used as the working LAADx model. Its performance was evaluated at 3 speeds, using an in vitro pulsatile mock circulatory loop, with a pneumatic pump that can simulate diastolic heart failure conditions by adjusting the diastolic drive pressure.
Esophageal achalasia presenting as recurrent pneumonia in children: A case series.
Medicine (Baltimore)
November 2024
College of Medicine, King Khalid University, Abha, Saudi Arabia.
Esophageal achalasia (EA) is a rare primary esophageal motility disorder that is considered a rare etiology of dysphagia among infants and children. The proposed primary pathophysiology is related to the loss of ganglion cells in the distal esophageal sphincters, particularly in the Auerbachian muscle layer, which then leads to the dysmotility and failure of lower esophageal sphincter relaxation. Dysphagia, vomiting, poor weight gain, cough, and recurrent aspiration pneumonia are the most common presenting complaints.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!