Evaluation of Postoperative Damage to Anal Sphincter/Levator Ani Muscles with Three-Dimensional Vector Manometry after Sphincter-Preserving Operation for Rectal Cancer

Koda, Keiji; Yasuda, Hideki; Hirano, Atsushi; Kosugi, Chihiro; Suzuki, Masato; Yamazaki, Masato; Tezuka, Tohru; Higuchi, Ryota; Tsuchiya, Hironori; Saitô, Norio

doi:10.1016/j.jamcollsurg.2008.10.035

Cited by 17 publications

(13 citation statements)

References 13 publications

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“…Anorectal manometry is a common and reliable method of assessing physiological changes due to anatomical alterations after LAR [6,[10][11][12]. In the current study, the MRP and MSP were lower postoperatively, and did not recover to the preoperative levels until 12 months postoperatively, similar to another study [13].…”

Section: Discussionsupporting

confidence: 80%

“…A manometric evaluation showed that the SL and HPZ length were unchanged after uLAR-LSR in the present study, which indicated satisfactory outcomes for uLAR-LSR. This is particularly notable in light of a recent report showing that the HPZ length is a strong predictor of severe postoperative defecatory malfunction [10]. A previous study reported that the SL and HPZ length in uLAR without LSR were significantly decreased by 26 and 25%, respectively, compared with those undergoing anterior resection, as assessed at postoperative years 1-3.…”

Section: Discussionmentioning

confidence: 80%

“…Postoperative anastomotic leakage and local recurrence are also significant complications that can result in poor outcomes and may be related to survival. A meta-analysis of 612 patients with ISR from 21 studies reported that the mean anastomosis leakage rate was 10.5%, and the pooled rate of local recurrence was 9.5% [3].…”

Section: Introductionmentioning

confidence: 99%

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Levator–sphincter reinforcement after ultralow anterior resection in patients with low rectal cancer: the surgical method and evaluation of anorectal physiology

Kim

Yoon

et al. 2011

Surg Today

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 80%

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Levator–sphincter reinforcement after ultralow anterior resection in patients with low rectal cancer: the surgical method and evaluation of anorectal physiology

Kim

Yoon

et al. 2011

Surg Today

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“…As there are currently few reports of short- and long-term results, the patients were evaluated using mFIQL and manometry. Further prospective studies on the evaluation of anal function, including postoperative short- and long-term results, will be necessary (29,30). …”

Section: Discussionmentioning

confidence: 99%

Safety and feasibility of laparoscopic intersphincteric resection for a lower rectal tumor

et al. 2017

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The aim of the present study was to evaluate the short-term surgical outcomes of laparoscopic intersphincteric resection (ISR) for a lower rectal tumor in comparison with a case-control series of patients undergoing open ISR. Quality of life factors and anal function were also evaluated. Between July 2008 and April 2013, 103 patients with lower rectal cancer underwent laparoscopic surgery at the Surgical Oncology Department of Gifu University School of Medicine. A total of 25 patients with lower rectal cancer underwent ISR, and 19/25 patients who underwent laparoscopic ISR were compared with the control group of 6 patients who underwent open ISR. The technical feasibility and safety of ISR, and the short- and long-term outcomes following laparoscopic ISR were evaluated. Additional data associated with fecal incontinence conditions of the postoperative patients were evaluated using the Modified Fecal Incontinence Quality of Life scale. There was no recorded perioperative mortality, three complications were observed to occur in three patients and the morbidity rate was 15.8%. The postoperative complications detected included bleeding in one patient and ileus in two patients of the laparoscopic ISR group. The rate of severe complications of grade ≥3a was 15.8% and that of grade ≥3b was 5.3%. In the matched case-control study, blood loss was significantly lower in the laparoscopic ISR group. The median postoperative hospital stay was 14.1 days in the laparoscopic ISR group, which was significantly shorter compared with in the open ISR group (18.7 days). Cancer recurrence was detected in one (5%) patient in a single inguinal lymph node. No significant differences between the ISR and ultra-low anterior resection (ULAR) groups were observed in the maximum resting and maximum squeeze pressures; the outcomes for anal function and fecal incontinence were the same for ISR and ULAR. Thus, laparoscopic ISR for lower rectal cancer may provide a benefit in the early postoperative period without increasing morbidity or mortality.

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“…6 Although more patients with CRC live longer after diagnosis due to early detection and improved treatments, surgical procedures and chemoradiation for CRC may impact on normal pelvic floor function through damage to muscular, neural, and fascial structures. [7][8][9] Post-operatively patients frequently complain of impaired bowel function, such as incomplete evacuation, excessive flatus, fecal urgency, straining at stool, perianal soreness or itching, bloating, and fecal incontinence. 10 Among all bowel dysfunction, fecal incontinence in particular is a prevalent symptom after CRC surgery with a reported incidence from 3.2% to 79.3%.…”

Section: Introductionmentioning

confidence: 99%

Pelvic floor muscle training for bowel dysfunction following colorectal cancer surgery: A systematic review

Lin

Granger

Denehy

et al. 2014

Neurourol. Urodynam.

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Evaluation of Postoperative Damage to Anal Sphincter/Levator Ani Muscles with Three-Dimensional Vector Manometry after Sphincter-Preserving Operation for Rectal Cancer

Cited by 17 publications

References 13 publications

Levator–sphincter reinforcement after ultralow anterior resection in patients with low rectal cancer: the surgical method and evaluation of anorectal physiology

Levator–sphincter reinforcement after ultralow anterior resection in patients with low rectal cancer: the surgical method and evaluation of anorectal physiology

Safety and feasibility of laparoscopic intersphincteric resection for a lower rectal tumor

Pelvic floor muscle training for bowel dysfunction following colorectal cancer surgery: A systematic review

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