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[Problems with continence after deep pelvic anastomoses in rectal carcinoma]
J Michek1, M Sutorý, P Zelnícek
1Centrum výzkumu speciální chirurgie a traumatologie MZ CR-Urazová nemocnice v Brnĕ.
Acta Medica (Hradec Kralove). Supplementum
|January 1, 1997
Summary
Post-rectal surgery incontinence in 15 patients was evaluated using multiple diagnostic methods. Causes were functional and extrasphincteric, not organic sphincter damage, suggesting conservative treatment effectiveness.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Diagnostic Imaging
Context:
- Postoperative fecal incontinence following lower rectal cancer surgery presents a significant clinical challenge.
- Surgical procedures like deep pelvic or coloanal anastomosis can impact anorectal function.
- Comprehensive evaluation is crucial for understanding the etiology of incontinence.
Purpose:
- To investigate the underlying causes of partial fecal incontinence in patients after lower rectal cancer surgery.
- To assess the role of various diagnostic modalities in evaluating post-surgical incontinence.
- To determine the nature of sphincter integrity and functional deficits.
Summary:
- Fifteen patients with partial incontinence post-lower rectal cancer surgery underwent evaluation via anorectal manometry, EMG, transrectal sonography, defecography, and Colonic Transit Time.
- No significant organic damage to the sphincters was identified in any patient.
- The primary causes of incontinence were found to be extrasphincteric and functional, rather than direct sphincter injury.
Impact:
- Findings suggest that functional and extrasphincteric factors are the predominant causes of incontinence in this patient group.
- Conservative management strategies are likely to be effective for these types of functional deficits.
- This study aids in refining diagnostic approaches and treatment planning for post-surgical incontinence.