Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
UO Gastroenterologia, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy.
Neurogastroenterol Motil. 2022 Sep;34(9):e14335. doi: 10.1111/nmo.14335. Epub 2022 Feb 27.
Anorectal manometry (ARM) comprehensively assesses anorectal sensorimotor functions.
This review examines the indications, techniques, interpretation, strengths, and weaknesses of high-resolution ARM (HR-ARM), 3-dimensional high-resolution anorectal manometry (3D-HR-ARM), and portable ARM, and other assessments (i.e., rectal sensation and rectal balloon expulsion test) that are performed alongside manometry. It is based on a literature search of articles related to ARM in adults. HR-ARM and 3D-HR-ARM are useful for diagnosing defecatory disorders (DD), to identify anorectal sensorimotor dysfunction and guide management in patients with fecal incontinence (FI), constipation, megacolon, and megarectum; and to screen for anorectal structural (e.g., rectal intussusception) abnormalities. The rectal balloon expulsion test is a useful, low-cost, radiation-free, outpatient assessment tool for impaired evacuation that is performed and interpreted in conjunction with ARM. The anorectal function tests should be interpreted with reference to age- and sex-matched normal values, clinical features, and results of other tests. A larger database of technique-specific normal values and newer paradigms of analyzing anorectal pressure profiles will increase the precision and diagnostic utility of HR-ARM for identifying abnormal mechanisms of defecation and continence.
肛肠测压（ARM）全面评估肛肠感觉运动功能。
本文综述了高分辨率肛肠测压（HR-ARM）、三维高分辨率肛肠测压（3D-HR-ARM）和便携式 ARM 以及与测压同时进行的其他评估（如直肠感觉和直肠球囊排出试验）的适应证、技术、解读、优势和不足。这是基于对成人 ARM 相关文献的检索。HR-ARM 和 3D-HR-ARM 可用于诊断排便障碍（DD），识别肛肠感觉运动功能障碍，并指导失禁、便秘、巨结肠和巨直肠患者的管理；以及筛查肛肠结构（如直肠套叠）异常。直肠球囊排出试验是一种有用的、低成本的、无辐射的、门诊评估工具，用于评估排空障碍，与 ARM 一起进行和解读。肛肠功能检查应参考年龄和性别匹配的正常值、临床特征和其他检查结果进行解读。更大的特定技术正常值数据库和分析肛肠压力曲线的新范例将提高 HR-ARM 识别异常排便和控便机制的准确性和诊断效用。
