Rectal resection with low anastomosis: functional outcome

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.

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.