Abstracts
2000 Digestive Disease Week

# 2242 Manometric Assessment of an Artificial Bowel Sphincter in 12 Patients.
Guillaume Savoye, Anne Marie Leroi, Philippe Denis, Philippe

Ducrotte, Francis Michot, Rouen, France BACKGROUND: The aim of this study was to identify the relationship between functional clinical results after artificial bowel sphincter (ABS) implants and manometric assessment. PATIENTS AND METHODS: We studied 12 consecutive patients with an ABS implant. A postoperative manometric study was performed including, with a closed and opened cuff, resting and squeezing pressures, opening characteristics and pressure during straining. The relationship between postoperative findings, clinical outcome and preoperative manometry were investigated. Anal pressure after rectal distension with a closed cuff was studied in 7 patients. RESULTS: Continence for solid stools was achieved in all 12 patients. Anal resting pressures were 108±22 cm of H20 with no difference between patients with postoperative gas or liquid stool incontinence and continent patients. Rectal distension induced anal relaxation in 6 patients out of 7. Characteristics of the cuff opening phase were reproducible. Total duration of cuff opening was 113+/-8 seconds with an amplitude of 60±22 % and with residual pressure which was correlated to the preoperative resting pressure. The total duration of the opening phase in patients with defecation difficulties (47±24 s, mean± SD, range: 0-65) was shorter than that in patients without defecation difficulties (178±78 s, range: 100-320, P=0.0022). Amplitude, residual pressures and opening time were not different between patients with or without defecation difficulties. CONCLUSION: Postoperative defecation difficulties after implantation of an artificial anal sphincter are related to a short duration of the opening of the cuff. Anal sphincter played a role in postoperative resting anal pressures and allow relaxation even if the cuff was closed.