Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2012
Anorectal function after partial intersphincteric resection in ultra-low rectal cancer.
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Gong X, Jin Z, Zheng Q
Аннотация
AIM: To investigate the feasibility and efficacy of intersphincteric resection (ISR), in terms of postoperative anorectal function, for ultra-low rectal cancer in mainland China.
METHOD: A total of 43 patients who consecutively underwent curative partial ISR for ultra-low rectal cancer between 2006 and 2009 were enrolled in the study. Defaecatory function was assessed, using detailed questionnaires, 3, 6 and 12 months after surgery. The Wexner score was used to assess faecal continence, and anal manometry studies were performed to analyse anal sphincter function.
RESULTS: Overall defaecatory function was assessed as being satisfactory in 41 of 43 patients. Twelve months after surgery, the mean Wexner score was 4.0 ± 3.6. Anal manometry studies showed a significant change at 3 months and further, gradual, improvement over the following year. During the postoperative period, maximum squeeze pressure reached a normal value of 174.1 ± 19.5 mmHg (P = 0.041) by 6 months and resting pressure was 42.4 ± 5.6 mmHg by 12 months, which was close to the preoperative level (P = 0.038).
CONCLUSION: Because of the satisfactory recovery of defaecatory function and good oncological results, partial ISR may be recommended as an effective sphincter-preserving operation for patients with ultra-low rectal cancer.
METHOD: A total of 43 patients who consecutively underwent curative partial ISR for ultra-low rectal cancer between 2006 and 2009 were enrolled in the study. Defaecatory function was assessed, using detailed questionnaires, 3, 6 and 12 months after surgery. The Wexner score was used to assess faecal continence, and anal manometry studies were performed to analyse anal sphincter function.
RESULTS: Overall defaecatory function was assessed as being satisfactory in 41 of 43 patients. Twelve months after surgery, the mean Wexner score was 4.0 ± 3.6. Anal manometry studies showed a significant change at 3 months and further, gradual, improvement over the following year. During the postoperative period, maximum squeeze pressure reached a normal value of 174.1 ± 19.5 mmHg (P = 0.041) by 6 months and resting pressure was 42.4 ± 5.6 mmHg by 12 months, which was close to the preoperative level (P = 0.038).
CONCLUSION: Because of the satisfactory recovery of defaecatory function and good oncological results, partial ISR may be recommended as an effective sphincter-preserving operation for patients with ultra-low rectal cancer.