Anorectal physiology after anterior resection and pull-through operation.

Area of Science:

• Gastroenterology and Colorectal Surgery
• Neurogastroenterology and Motility
• Anal Sphincter Function

Background:

• Low anterior resection and Bacon-type pull-through operations involve rectal excision, potentially impacting anal sphincter function and continence.
• Understanding the electromechanical relationship of the anal sphincter is crucial for evaluating functional outcomes after these procedures.

Purpose of the Study:

• To investigate sensory and motor functions of the anal sphincter in patients after low anterior resection and pull-through operations.
• To define the electromechanical relationship in anal sphincter activity post-rectal surgery.
• To assess the preservation of continence mechanisms following rectal excision.

Main Methods:

• Performed sensory and motor investigations on normal subjects (controls).
• Evaluated patients who underwent low anterior resection of the rectum.
• Assessed patients following a Bacon-type pull-through operation.

Main Results:

• Motor findings, sensory threshold, and sensation quality in low anterior resection patients were similar to controls.
• The anorectal inhibitory reflex was often replaced by sphincter contraction after pull-through operations.
• In some pull-through patients, the anorectal inhibitory reflex and fine discriminatory sensation were preserved.

Conclusions:

• Mechanisms of anal sphincter continence appear to be preserved even after complete rectal excision.
• Surgical interventions like low anterior resection and pull-through operations may retain significant functional aspects of continence.
• Further research into sphincter preservation post-rectal surgery is warranted.