[Comparative evaluation of the anal sphincter function after sphincter-sparing operations in diffuse polyposis].

Area of Science:

• Colorectal Surgery
• Gastrointestinal Physiology
• Surgical Outcomes

Background:

• Sphincter-preserving operations are crucial for maintaining quality of life after colorectal resections.
• Assessing the functional impact of different surgical techniques on anal sphincter integrity is essential.

Purpose of the Study:

• To analyze the functional outcomes of various sphincter-preserving colorectal operations.
• To compare the effects of colon pull-through versus ileorectal anastomosis on anal sphincter function.

Main Methods:

• Analysis of clinical experience in 76 patients undergoing sphincter-preserving surgeries.
• Evaluation of neuro-reflex activity using sphicterometry, electromyography, and electromanometry.

Main Results:

• Colon pull-through procedures (abdomino-anal resection with colon pull-through) resulted in significant neuro-reflex activity destruction or reduction in 80% of patients for the internal anal sphincter and 45% for the external anal sphincter.
• The specific segment of the colon used in pull-through operations did not influence rectal obturation outcomes.
• Ileorectal anastomosis demonstrated significantly better functional results, with a return to normal values within 18 months post-surgery.

Conclusions:

• Colon pull-through operations lead to substantial and often irreversible damage to anal sphincter function.
• Ileorectal anastomosis is a superior technique for preserving rectal obturation function compared to colon pull-through methods.