Top

Techniques in Coloproctology

Published in:

Open Access 01-05-2014 | Technical Note

Usefulness of 3D transperineal ultrasound in severe stenosis of the anal canal: preliminary experience in four cases

Authors: M. Kołodziejczak, G. A. Santoro, R. Z. Słapa, T. Szopiński, I. Sudoł-Szopińska

Published in: Techniques in Coloproctology | Issue 5/2014

Abstract

Background

Organic or functional anal canal stenoses are uncommon conditions that occur in the majority of cases as a consequence of anal diseases. A proper assessment is fundamental for decision making; however, proctological examination and endoanal ultrasound are often unfeasible or very difficult to perform even under local or general anesthesia. We therefore began to use 3D transperineal ultrasound to assess patients. The aim of this study was to compare the results of evacuation proctography and 3D transperineal ultrasound in patients with severe anal canal stenosis.

Methods

Four consecutive patients with high-grade anal canal stenosis were evaluated using both proctography and 3D transperineal ultrasound with a micro-convex transducer between March and June 2011.

Results

In all cases, 3D transperineal ultrasound provided detailed information on the length and level of stenosis and on the integrity of the anal sphincters.

Conclusions

Our preliminary experience suggests that 3D transperineal ultrasound makes it possible to plan optimal surgical treatment.

Brisinda G, Vanella S, Cadeddu F et al (2009) Surgical treatment of anal stenosis. World J Gastroenterol 15:1921–1928PubMedCentralPubMedCrossRef

Fields S, Rosainz L, Korelitz B, Panagopoulos G, Schneider J (2007) Rectal strictures in Crohn’s disease and coexisting perirectal complications. Infl Bowel Disease 14:29–31CrossRef

Liberman H, Thorson AG (2000) Anal stenosis. Am J Surg 179:325–329PubMedCrossRef

Oh C, Divino CM, Steinhagen RM (1995) Anal fissure. 20-year experience. Dis Colon Rectum 38:378–382PubMedCrossRef

Perez CA, Lee HK, Georgiou A, Lockett MA (1994) Technical factors affecting morbidity in definitive irradiation for localized carcinoma of the prostate. Int J Radiat Oncol Biol Phys 28:811–819PubMedCrossRef

Hayne D, Vaizey CJ, Boulos PB (2001) Anorectal injury following pelvic radiotherapy. Br J Surg 88:1037–1048PubMedCrossRef

Johnston MJ, Robertson GM, Frizelle FA (2003) Management of late complications of pelvic radiation in the rectum and anus: a review. Dis Colon Rectum 46:247–259PubMedCrossRef

Marti MC (1990) Anorectal strictures. In: Marti MC, Givel JC (eds) Surgery of anorectal diseases. Springer, Berlin, Heidelberg, pp 234–238CrossRef

Santoro GA, Di Falco G (2006) Endosonographic anatomy of the normal anal canal. In:Santoro GA, Di Falco G (eds). Benign anorectal diseases. Diagnosis with endoanal and endorectal ultrasonography and new treatment options. Springer Italy, Milan pp 35–54

10.

Santoro GA, Fortling B (2006) The advantages of volume rendering in three-dimensional endosonography of the anorectum. Dis Colon Rectum 50:359–368CrossRef

11.

Thakar R, Sultan DC (2004) Anal endosonography and its role in assessing the incontinent patient. Best Pract Res Clinic Obstet Gynaecol 18:157–173CrossRef

12.

Cataldo PA, Senagore A, Luchtefeld MA (1993) Intrarectal ultrasound in evaluation of perirectal abscesses. Dis Colon Rectum 36:554–558PubMedCrossRef

13.

Lindsey I, Humphreys MM, George BD, Mortensen NJ (2002) The role of anal ultrasound in the management of anal fistulas. Colorectal Dis 4:118–122PubMedCrossRef

14.

Worrell S, Horvath K, Blakemore T, Flum D (2004) Endorectal ultrasound detection of focal carcinoma within rectal adenomas. Am J Surg 187:625–629PubMedCrossRef

15.

Santoro GA, Fortling B (2006) New technical developments in endoanal and endorectal ultrasonography. In: Santoro GA, Di Falco G (eds) Benign anorectal diseases. Diagnosis with endoanal and endorectal ultrasonography and new treatment options, Springer Italy, pp 13–26CrossRef

16.

Giovannini M, Ardizzone S (2006) Anorectal ultrasound for neoplastic and inflammatory lesions. Best Pract Res ClinGastroenterol 20:113–135CrossRef

17.

Oom DM, West RL, Schouten WR, Steensma AB (2012) Detection of anal sphincter defects in female patients with fecal incontinence: a comparison of 3-dimensional transperineal ultrasound and 2-dimensional endoanal ultrasound. Dis Colon Rectum 55:646–652PubMedCrossRef

18.

Santoro GA (2012) Which method is best for imaging of anal sphincter defects? Dis Colon Rectum 55:625–627PubMedCrossRef

19.

Abdool Z, Sultan AH, Thakar R (2012) Ultrasound imaging of the anal sphincter complex: a review. Br J Radiol 85:865–875PubMedCentralPubMedCrossRef

20.

Murad-Regadas SM, Regadas FS, Barreto RG, Rodrigues LV, Fernandes GO, Lima DM (2010) Is dynamic two-dimensional anal ultrasonography useful in the assessment of anismus? A comparison with manometry. Arq Gastroenterol 47:368–372PubMedCrossRef

21.

Sudoł-Szopinńska I, Radkiewicz J, Szopiński T, Panorska AK, Jakubowski W, Kawka J (2010) Postpartum endoanal ultrasound findings in primiparous women after vaginal delivery. Acta Radiol 51:819–824PubMedCrossRef

22.

Rubens DJ, Strang JG, Bogineni-Misra S, Wexler IE (1998) Transperineal sonography of the rectum: anatomy and pathology revealed by sonography compared with CT and MR imaging. AJR 170:637–642PubMedCrossRef

23.

Kleinubing H, Jannini JF, Malafaia O, Brenner S, Pinho M (2000) Transperineal ultrasonography: new method to image the anorectal region. Dis Colon Rectum 43:1572–1574PubMedCrossRef

24.

Stewart LK, McGee J, Wilson SR (2001) Tranperineal and transvaginalsonography of perianal inflammatory disease. AJR 177:627–632PubMedCrossRef

25.

Valsky DV, Cohen SM, Lipschuetz M, Hochner-Celnikier D, Yagel S (2012) Three-dimensional transperineal ultrasound findings associated with anal incontinence after intrapartum sphincter tears in primiparous women. Ultrasound Obstet Gynecol 39:83–90PubMedCrossRef

26.

Zufferey G, Perneger T, Robert-Yap J, Skala K, Roche B (2011) Accuracy of measurement of puborectal contraction by perineal ultrasound in patients with faecal incontinence. Colorectal Dis 13:234–237CrossRef

27.

Roos AM, Abdool Z, Sultan AH, Thakar R (2011) The diagnostic accuracy of endovaginal and transperineal ultrasound for detecting anal sphincter defects: the PREDICT study. Clin Radiol 66:597–604PubMedCrossRef

28.

Roche B, Deléaval J, Fransioli A, Marti MC (2001) Comparison of transanal and external perineal ultrasonography. Eur Radiol 11:1165–1170PubMedCrossRef

29.

Fleiss JL (1981) Statistical Methods for Rates and Proportions, 2nd edn. Wiley, New York

30.

Terra MP, Beets-Tan RG, van Der Hulst VP et al (2005) Anal sphincter defects in patients with fecal incontinence: endoanal versus external phased-array MR imaging. Radiology 236:886–895PubMedCrossRef

Title: Usefulness of 3D transperineal ultrasound in severe stenosis of the anal canal: preliminary experience in four cases
Authors: M. Kołodziejczak
G. A. Santoro
R. Z. Słapa
T. Szopiński
I. Sudoł-Szopińska
Publication date: 01-05-2014
Publisher: Springer Milan
Published in: Techniques in Coloproctology / Issue 5/2014
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-013-1078-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Usefulness of 3D transperineal ultrasound in severe stenosis of the anal canal: preliminary experience in four cases

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2014

Transanal minimally invasive surgery for total mesorectal excision (TAMIS–TME): results and experience with the first 20 patients undergoing curative-intent rectal cancer surgery at a single institution

Successful treatment for Cronkhite-Canada syndrome with endoscopic mucosal resection and salazosulfapyridine

Isolated ischemic colitis may mimic occluding cancer in elderly patients

Correction of anterior rectal wall prolapses after insertion of a vaginal pessary

TVRAM flap: a modified rectus abdominis musculocutaneous flap for anal cancer salvage surgery

Peroxide-enhanced endoanal ultrasound in preoperative assessment of complex fistula-in-ano