Decrease in the anorectal pressure gradient after low anterior resection of the rectum

Williamson, M. E. R.; Lewis, Wyn G.; Holdsworth, P. J.; Finan, P. J.; Johnston, D.

doi:10.1007/bf02257786

Cited by 73 publications

(39 citation statements)

References 14 publications

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“…Changes in the colon compliance associated with the decrease of the anal resting pressure lead to a significant change of the pressure gradient between the rectum and anal canal [7]. In a normal individual the pressure of the distal anal canal is higher than the pressure of the proximal anal canal, while the pressure of the rectum remains lower.…”

Section: Discussionmentioning

confidence: 99%

Manometric and clinical evaluation of patients after low anterior resection for rectal cancer

et al. 2004

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The aim of this study was to examine the anorectal physiological and clinical changes that occur after low anterior resection for rectal cancer. Since 1998, 30 patients underwent laboratory tests of anorectal function, preoperatively and 1 month and 6 months after low anterior resection. Postoperatively all patients presented with increased bowel frequency, 60% of the patients with mild soiling and 30% with urgency for defecation. Six months after surgery there was a significant improvement of these symptoms. The anal resting pressure was significantly decreased postoperatively, while maximum squeezing pressure remained unchanged. The rectoanal inhibitory reflex was absent in 80% of the patients and at 6 months after surgery it tended to recover. Rectal capacity and compliance were reduced in all patients. In the current study, the majority of patients demonstrated manometric anorectal changes and clinical anorectal function disorders during the first year after surgery. We observed that these disorders correlated with the low level of the anastomosis.

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Section: Discussionmentioning

confidence: 99%

Manometric and clinical evaluation of patients after low anterior resection for rectal cancer

et al. 2004

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“…Several studies have described the ''anterior resection syndrome'' as an increased number of daily bowel movements, clustering, anal incontinence, and soiling after this operation. 7 As preoperative RT frequently includes irradiation to the anal canal, an additional impairment of anal function may result. There are few previous studies addressing this problem and knowledge is limited concerning the long-term effects on anal function in patients treated with preoperative RT and low anterior resection.…”

mentioning

confidence: 99%

Long-Term Effect of Preoperative Radiation Therapy on Anorectal Function

Pollack

Holm

Cedermark

et al. 2006

Diseases of the Colon &Amp; Rectum

203

111

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“…A syndrome of urgency, frequency and sometimes incontinence has been associated with anterior resection [41]. Various mechanisms have been put forth and implicated alone or in conjunction with all of the components of normal continence: injury to the sphincter muscles or to the nerves or alteration of rectal capacity and compliance following loss of the normal reservoir [42][43][44][45][46][47][48][49][50]. Authors have proposed the three mechanisms as possibly contributory, with studies identifying decreases in resting pressures, others to decrease in compliance and maximum tolerable volume and still others alteration of the rectoanal inhibitory reflex (Table 1).…”

Section: Morbidity and Mortalitymentioning

confidence: 99%

Sphincter-saving anastomosis for rectal cancer: an overview

Latulippe

Wexner

1999

Techniques in Coloproctology

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To review the role of sphincter-saving anastomosis in the treatment of low rectal cancer, through a review of literature, we consider the oncologic value and the impact on morbidity and mortality of abdominoperineal resection compared specifically to sphincter-saving procedures. We also review the functional results reported after sphinctersaving procedures. Sphincter-saving procedures are now considered to be the first therapeutic choice in the approach to low rectal cancer. This choice is based on both the appraisal of the oncologic validity of this option and also on the realization of the significant negative impact on the quality of life to patients after an abdominoperineal resection. Functional results after sphincter saving procedures seem to be related to the length of the remaining rectal stump and the addition of a colonic J-pouch and have been documented as beneficial. In conclusion our review supports the trend towards sphincter-saving procedures as a first choice in the treatment of low rectal cancer. Tumours located at or near the sphincter or the dentate line and preexisting incontinence still remain indications for abdominoperineal resection.

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Decrease in the anorectal pressure gradient after low anterior resection of the rectum

Cited by 73 publications

References 14 publications

Manometric and clinical evaluation of patients after low anterior resection for rectal cancer

Manometric and clinical evaluation of patients after low anterior resection for rectal cancer

Long-Term Effect of Preoperative Radiation Therapy on Anorectal Function

Sphincter-saving anastomosis for rectal cancer: an overview

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