Usefulness of Preoperative Anorectal Manometry for Ostomy Closure: A Cross-sectional Study

Abstract

Introduction: For several reasons, a patient may be taken to a colostomy for closure as soon as possible. However, their treatment may vary, and predicting adequate continence after colostomy closure can be difficult. The objective is to characterize preoperative manometry because, in Colombia, few cases describe its usefulness. Methods: A descriptive cross-sectional study of adult patients treated in two gastroenterology centers in Colombia between 2018 and 2020. Results: Of 316 patients, 13 were indicated manometry before colos­tomy closure, predominantly women (69%), with an average age of 51.69 years (standard deviation: 24.18). When evaluating the basal pressures of the anal sphincter, we noted 68% hypotonia, 16% hypertonia, and 16% normal pres­sures. The voluntary contraction test was abnormal in 25%, and a pattern of dyssynergic defecation was observed in 30%, all with type III patterns. The inhibitory rectoanal reflex was present in 92%, with an abnormal balloon ex­pulsion test in 100% of patients. More than 70% of patients persisted with the colostomy in situ after the first year of construction and 30% beyond 36 months. Conclusions: The present study posits questions about the cost-effectiveness of anorectal manometry before colostomy closure, which requires corroboration by studies with more patients and more robust methodological designs. © 2023 Asociación Colombiana de Gastroenterología.