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Rectal resection with low anastomosis: functional outcome.

K E Matzel1, B Bittorf, K Günther

  • 1Department of Surgery, University of Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany. Klaus.Matzel@chir.med.uni-erlangen.de

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|August 20, 2003
PubMed
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Rectal cancer surgery impacts bowel function, with specific procedures like intersphincteric resection causing greater continence issues. Despite functional deficits, most patients report high satisfaction with outcomes.

Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Rectal cancer resection necessitates functional outcome assessment.
  • Understanding the impact of different surgical techniques on bowel function is crucial for patient care.

Purpose of the Study:

  • To evaluate the functional outcomes, specifically bowel continence, after various rectal resection procedures.
  • To investigate the influence of radiochemotherapy and reconstructive techniques on functional results.

Main Methods:

  • A cohort of 139 patients undergoing anterior, low anterior, or intersphincteric resection for rectal cancer were studied.
  • Functional outcomes were assessed using the Cleveland Clinic Continence Score and anorectal manometry.
  • Data were collected postoperatively at approximately 108 weeks for questionnaires and 26 weeks for manometry.

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Main Results:

  • Continence scores varied significantly by procedure, being highest (poorest continence) after intersphincteric resection.
  • Radiochemotherapy further impaired continence and reduced rectal pressures.
  • Reduced maximal tolerable volume and rectal compliance were observed after low anterior and intersphincteric resections.
  • Significant correlations were found between continence scores and manometric parameters.

Conclusions:

  • The extent of functional impairment after rectal resection is determined by the surgical procedure and reconstruction method.
  • Radiochemotherapy adversely affects functional outcomes.
  • Despite objective functional reductions, a high level of patient satisfaction with functional outcomes was reported.