BACKGROUND: The aim of this study was to examine correlations between pressure profile of the anal canal and postoperative defecatory disorder after sphincter-preserving operation (SPO) for rectal cancer. STUDY DESIGN: Using three-dimensional vector manometry, pressure profile and length of the anal canal were evaluated more than 1 year after SPO according to operation method and degree of postoperative defecatory function in 53 patients with rectal cancer. RESULTS: Compared with high anterior resection as a control, the anal canal was shorter in operations with a pelvic floor maneuver, namely, low anterior resection, ultra-low anterior resection, and intersphincteric resection. Patients with postoperative defecatory disorder showed significantly shorter anal canal length than patients with fair function. Length of the circular high-pressure zone (> or = 20 mmHg) < 20 mm in the resting state was a strong predictor of severe postoperative defecatory malfunction, with Wexner score> or =10. CONCLUSIONS: Operative maneuvers at the pelvic floor during SPO for rectal cancer may damage anal sphincter or levator ani muscles. The circular high-pressure zone can be measured only by three-dimensional manometry and may offer a useful indicator of sphincter damage after SPO for rectal cancer.
BACKGROUND: The aim of this study was to examine correlations between pressure profile of the anal canal and postoperative defecatory disorder after sphincter-preserving operation (SPO) for rectal cancer. STUDY DESIGN: Using three-dimensional vector manometry, pressure profile and length of the anal canal were evaluated more than 1 year after SPO according to operation method and degree of postoperative defecatory function in 53 patients with rectal cancer. RESULTS: Compared with high anterior resection as a control, the anal canal was shorter in operations with a pelvic floor maneuver, namely, low anterior resection, ultra-low anterior resection, and intersphincteric resection. Patients with postoperative defecatory disorder showed significantly shorter anal canal length than patients with fair function. Length of the circular high-pressure zone (> or = 20 mmHg) < 20 mm in the resting state was a strong predictor of severe postoperative defecatory malfunction, with Wexner score> or =10. CONCLUSIONS: Operative maneuvers at the pelvic floor during SPO for rectal cancer may damage anal sphincter or levator ani muscles. The circular high-pressure zone can be measured only by three-dimensional manometry and may offer a useful indicator of sphincter damage after SPO for rectal cancer.
Authors: S Y Parnasa; H Chill; B Helou; A Cohen; R Alter; D Shveiky; I Mizrahi; M Abu-Gazala; A J Pikarsky; N Shussman Journal: Tech Coloproctol Date: 2022-09-12 Impact factor: 3.699
Authors: A G K McNair; R N Whistance; R O Forsythe; J Rees; J E Jones; A M Pullyblank; K N L Avery; S T Brookes; M G Thomas; P A Sylvester; A Russell; A Oliver; D Morton; R Kennedy; D G Jayne; R Huxtable; R Hackett; S J Dutton; M G Coleman; M Card; J Brown; J M Blazeby Journal: Colorectal Dis Date: 2015-11 Impact factor: 3.788