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Related Experiment Video

Updated: Dec 13, 2025

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Optimising functional outcomes in rectal cancer surgery.

Fabio Nocera1, Fiorenzo Angehrn1, Markus von Flüe1

  • 1Clarunis, Department of Visceral Surgery, University Centre for Gastrointestinal and Liver Disease, St Clara Hospital and University Hospital, Kleinriehenstrasse 30, 4058, Basel, Switzerland.

Langenbeck'S Archives of Surgery
|July 27, 2020
PubMed
Summary
This summary is machine-generated.

Functional disorders after rectal cancer surgery are common but often underestimated. This review explores causes, prevention, and treatment strategies for bowel, anorectal, and urogenital dysfunction following anterior resection (AR).

Keywords:
Functional outcomeHealth related quality of lifePelvic floorRectal cancerTotal mesorectal excision

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Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Functional Outcomes

Background:

  • Advances in rectal cancer surgery, including total mesorectal excision (TME) and minimally invasive techniques (laparoscopic, robotic, transanal-TME), have improved survival and sphincter preservation.
  • Despite surgical progress, functional disorders affecting bowel, anorectal, and urogenital systems remain prevalent and require significant attention.

Purpose of the Study:

  • To review the causes of dysfunction after anterior resection (AR) for rectal cancer.
  • To discuss preventive strategies and therapeutic options for post-AR functional disorders.
  • To evaluate the indications for low AR based on functional outcomes.

Main Methods:

  • Literature review of studies on functional outcomes after rectal cancer surgery.
  • Analysis of evidence regarding preventive and therapeutic strategies for bowel, anorectal, and urogenital dysfunction.
  • Comparison of functional outcomes across different surgical techniques, including robotic and transanal-TME.

Main Results:

  • Functional disorders are frequent and underestimated sequelae of rectal cancer surgery.
  • Robotic TME may offer benefits in preserving urogenital function compared to other minimally invasive approaches.
  • Low anterior resection syndrome (LARS) management involves stool regulation, pelvic floor therapy, and transanal irrigation; sacral nerve modulation is effective for incontinence.

Conclusions:

  • Restorative resection decisions should consider risk factors for dysfunction, with side-to-end anastomosis preferred.
  • Further high-quality studies are needed to clarify the benefits of intraoperative neuromonitoring and to establish indications for non-operative management or local excision.
  • While transanal-TME's functional superiority is unclear, robotic TME shows promise for urogenital function preservation.