Recovery of physiologic and clinical function after low anterior resection of the rectum for carcinoma

Abstract

Anal resting pressure decreased significantly after low anterior resection and did not recover in the course of the first year after operation. Moreover, the volume of an air-filled balloon in the neorectum that was required to elicit maximum inhibition of the anal sphincter was significantly less after anterior resection that before operation. These long-term and presumably permanent changes in physiologic behavior of the anoneorectum after low anterior resection provide an explanation for the failure of some patients to regain satisfactory bowel function following that procedure.

External Coloanal Anastomosis Without Covering Stoma in Low-Lying Rectal Cancer

“…This coincides with other studies reporting an incidence of frequent defecation in about 30% of patients [20,21]. Nerve injury may occur during eversion of the distal stump leading to postoperative fecal incontinence [12].…”

A novel animal model of long-term sustainable anal sphincter dysfunction

“…Patients may suffer from fecal incontinence due to partial or complete resection of the IAS. Fecal incontinence after ISR is mainly due to a decrease in resting pressure (2,(4)(5)(6)(7)(8).…”

“…Although ISR has become a common procedure and can avoid the need for permanent colostomy in patients with lower rectal cancer, postoperative anal sphincter dysfunction of varying degrees has become a major problem. One potential cause of such postoperative defecatory dysfunction is anal sphincter damage caused by surgery (2,(4)(5)(6)(7).…”

Causes and Prevention of Functional Disturbances Following Low Anterior Resection for Rectal Cancer

“…The reservoir function of the remaining rectum or the rectal replacement can be quantified with these parameters. A post-operative reduction in these parameters could be measured in patients compared with pre-operatively (5, 25,89,115,123,161), as well as in patients compared with healthy controls (25,39,154,158). Compliance is also influenced by the height of the anastomosis and the length of the rectal stump.…”