CORRELATION BETWEEN THE LEVEL OF COLORECTAL ANASTOMOSIS AND ANORECTAL FUNCTION

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Gastroenterology

Background:

• Anterior rectal resection is a common procedure for rectal and distal sigmoid colon cancers.
• Postoperative fecal incontinence is a frequent complication following anterior rectal resection.

Purpose of the Study:

• To investigate the impact of colorectal anastomosis level on anorectal functional outcomes after anterior rectal resection.
• To identify the relationship between anastomosis height and the severity of fecal incontinence and quality of life.

Main Methods:

• Prospective study analyzing 38 patients who underwent open or laparoscopic anterior rectal resection for rectal or distal sigmoid colon carcinoma.
• Anorectal function was evaluated six months post-surgery.
• Patients were categorized based on anastomosis level: high, mid, and low rectal anastomosis.

Main Results:

• Lower anastomosis levels were associated with a statistically significant increase in stool frequency, urgency, and impaired discrimination.
• Patients with lower anastomosis experienced more pronounced solid, liquid, and gas incontinence, and a greater need for diapers.
• Lower anastomosis levels correlated with significantly impaired quality of life and higher Wexner scores.

Conclusions:

• The level of colorectal anastomosis significantly influences postoperative anorectal function.
• Lower anastomosis levels lead to worse functional outcomes, including increased incontinence and reduced quality of life.
• Reduced neorectal capacity is identified as the primary pathophysiological factor contributing to these postoperative functional impairments.