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CC BY-NC-ND 4.0 · Journal of Coloproctology 2021; 41(01): 070-078
DOI: 10.1055/s-0041-1726078
Original Article

Normal Values and Associated Factors in High-resolution Anorectal Manometry in Healthy Vietnamese Adults

Valores normais e fatores associados na manometria anorretal de alta resolução em adultos vietnamitas saudáveis
Nguyen Ngoc Anh 
1   Hanoi Medical University, Hanoi, Vietnam
,
Le Dinh Tung 
1   Hanoi Medical University, Hanoi, Vietnam
,
Ngo Xuan Khoa 
1   Hanoi Medical University, Hanoi, Vietnam
,
Le Manh Cuong 
2   National Hospital of Traditional Medicine, Hanoi, Vietnam
,
Nguyen Xuan Hung 
3   Viet Duc Hospital, Hanoi, Vietnam
,
Nguyen Thi Thu Hang 
3   Viet Duc Hospital, Hanoi, Vietnam
,
Pham Phuc Khanh 
3   Viet Duc Hospital, Hanoi, Vietnam
,
Nguyen Van Huy 
4   Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
,
Vu Duy Kien 
5   OnCare Medical Technology Company Limited, Hanoi, Vietnam
› Author Affiliations Funding No funding or sponsorship was received for the present study or for the publication of the present article. The article processing charges were funded by the authors.
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Abstract

Introduction The present study aims to identify normal high-resolution anorectal manometry (HRAM) values and related factors in healthy Vietnamese adults.

Methods The present cross-sectional study was conducted at the Viet Duc hospital, Hanoi, Vietnam, during April and May 2019. Healthy volunteers were recruited to participate in the study. Anorectal measurement values from the digestive tract, including pressure, were recorded.

Results A total of 76 healthy volunteers were recruited. The mean functional anal canal length was 4.2 ± 0.5 cm, while the mean anal high-pressure zone length was 3.4 ± 0.5 cm. The mean defecation index was 1.4 ± 0.8, with values ranging from 0.3 to 5.0. The mean threshold volume to elicit the rectoanal inhibitory reflex (RAIR) was 18.1 mL. The mean rectal sensation values were 32.4 mL, 81.6 mL, and 159 mL for first sensation, desire to defecate, and urge to defecate, respectively. Dyssynergic patterns occurred in ∼ 50% of the study participants and included mainly types I (27.6%) and III (14.6%). There were significant differences between male and female patients in terms of maximum anal squeeze pressure, maximum anal cough pressure, maximum anal strain pressure, maximum rectal cough pressure, and maximum rectal strain pressure (all p < 0.01).

Conclusions The present study establishes normal HRAM values in healthy Vietnamese adults, particularly regarding normal values of anorectal pressure and rectal sensation. Further studies that include larger sample sizes should be conducted to further confirm the constants and their relationships.

Resumo

Introdução O presente estudo tem como objetivo identificar valores normais de manometria anorretal de alta resolução e fatores relacionados em adultos vietnamitas saudáveis.

Métodos O presente estudo transversal foi conduzido no hospital Viet Duc, Hanói, Vietnã, durante abril e maio de 2019. Voluntários saudáveis foram recrutados para participar do estudo. Valores de medição anorretal, incluindo pressão do trato digestivo, foram registrados.

Resultados Um total de 76 voluntários saudáveis foram recrutados. O comprimento funcional médio do canal anal foi de 4,2 ± 0,5 cm, enquanto o comprimento médio da zona anal de alta pressão foi de 3,4 ± 0,5 cm. O índice médio de defecação foi de 1,4 ± 0,8, com valores variando de 0,3 a 5,0. O volume limite médio para eliciar o reflexo inibitório retoanal (RAIR, sigla em inglês) foi de 18,1 mL. Os valores médios da sensação retal foram 32,4 mL, 81,6 mL e 159 mL para a primeira sensação, o desejo de defecar e a urgência de defecar, respectivamente. Os padrões dissinérgicos ocorreram em aproximadamente 50% dos participantes do estudo e incluíram principalmente os tipos I (27,6%) e III (14,6%). Houve diferenças significativas entre homens e mulheres na pressão de compressão anal máxima, pressão de tosse anal máxima, pressão de distensão anal máxima, pressão de tosse retal máxima e pressão de distensão retal máxima (todos p < 0,01).

Conclusões O presente estudo estabelece valores normais de HRAM em adultos vietnamitas saudáveis, particularmente no que diz respeito aos valores normais de pressão anorretal e sensação retal. Mais estudos que incluam tamanhos de amostra maiores devem ser realizados a fim de confirmar melhor as constantes e suas relações.

Keywords

high-resolution anorectal manometry - anorectal manometry - normal values - healthy people - Vietnam

Palavras-chave

manometria anorretal de alta resolução - manometria anorretal - valores normais - pessoas saudáveis - Vietnã

Ethics Approval and Consent to Participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Hanoi Medical University committee, Vietnam, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval to conduct the study was obtained from the committee of the Hanoi Medical University, Vietnam, under decision no. 21NCS17/HDDDDHYHN, dated 08/02/2018. All patients gave their written, informed consent prior to inclusion in the study.


Consent for Publication

Not applicable.


Availability of Data and Materials

The datasets used and/or analyzed during the present study are available from the corresponding author upon reasonable request.


Authors' Contributions

Anh N. N. and Kien V. D.: study concept, study design, acquisition of data, statistical analysis, data interpretation, drafting of the manuscript. Tung L. D. and Hung N. X: study concept, critical revision of the manuscript. Cuong L. M., Hung N. X., Hang N. T. T. and Huy N. V.: data interpretation, critical revision of the manuscript. All authors have read and approved the final manuscript.




Publication History

Received: 01 October 2020

Accepted: 18 January 2021

Article published online:
19 March 2021

© 2021. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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