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Background and purpose: Anorectal manometry is a suitable diagnostic method in children with chronic constipation and could provide useful information on the causes of constipation. This study was done to evaluate the therapeutic response of standard treatment and improve the diagnostic method via assessment of manometric parameters before and after the standard treatment. Materials and methods: In a randomized clinical trial, anorectal manometry was performed in 48 patients including 31 male (with the mean age of 6.8±1.08 years) with chronic constipation. The manometry parameters were compared before and after six months therapeutic period. Results: Forty eight children with chronic constipation underwent anorectal manometric testing. Basal anal pressure decreased in standard treatment (P<0.004). According to clinical symptoms, acceptable therapeutic response was achieved in 27 (75%) patients. Severe changes in sphincter relaxation were seen at one second after rectal dilatation phase. But no significant differences were seen in Amplitude and duration of relaxation in volumes higher than 30cc. Conclusion: Standard treatment had no long term effect on Duration of Relaxation, however, it could play a role in improving the status of patient by influencing Amplitude of relaxation. More changes were seen at one second after rectal dilatation phase, hence, the length of manometry procedure can be shortened. [ABSTRACT FROM AUTHOR]

Background and purpose: Todays one of the most common anorectal problems is hemorrhoid.Minor symptom of disease can be treated by medical treatment but at high grade disease we should consider surgery. Although conventional surgery is standard operation for hemorrhoid, it is associated with some complication. Many technique were designed to overcome these problems. One of these procedures is Ligasure hemorrhoidectomy that this study was done to compare it with conventional hemorrhoidectomy. Materials and methods: This was a randomized cilinical trial study of 60 patients with thirddegree or four-degree hemorrhoid that was divided into two groups randomly. Operative time, bleeding, postoperative pain, rate of wound healing were recorded. Results: we randomized 60 patients, 30 to Ligasure and 30 to conventional. There were no difference in patients demographic datas. Operative time, bleeding, pain at second postoperative day in Ligasure group was less than the conventional. There was no difference in rate of healing, pain at first day postoperation and complications. Conclusion: Ligasure hemorrhoidectomy is a safe and feasible procedure and in comparison with conventional hemorrhoidectomy cause more pain control and satisfaction. [ABSTRACT FROM AUTHOR]