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Related Experiment Videos

Total anorectal reconstruction

J E Abercrombie1, N S Williams

  • 1Surgical Unit, Royal London Hospital Medical College, Whitechapel, UK.

The British Journal of Surgery
|April 1, 1995
PubMed
Summary

Total anorectal reconstruction (TAR) can help patients avoid permanent abdominal stomas after rectal excision surgery. While some incontinence may occur, the psychological benefits of avoiding a stoma are significant for most patients.

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Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Patient Quality of Life

Background:

  • Abdominal stomas are associated with significant physical and psychological distress.
  • Total anorectal reconstruction (TAR) has been explored as an alternative to permanent stomas following abdominoperineal excision of the rectum (APER).

Purpose of the Study:

  • To review published series of total anorectal reconstruction (TAR).
  • To evaluate the oncological safety and functional outcomes of TAR compared to permanent stomas.

Main Methods:

  • Systematic review of published studies on total anorectal reconstruction (TAR).
  • Analysis of oncological outcomes (survival) and functional results (anorectal function, incontinence).

Main Results:

  • No evidence suggests TAR adversely affects cancer survival rates.
  • Patients undergoing TAR experience variable anorectal function, with many reporting some degree of incontinence.
  • The psychological benefit of avoiding an abdominal stoma is highly valued by patients, often outweighing functional deficits.

Conclusions:

  • Total anorectal reconstruction (TAR) is a viable alternative to permanent stomas in selected patients undergoing abdominoperineal excision of the rectum (APER).
  • Improvements in surgical techniques and neorectal emptying methods enhance the feasibility of TAR.
  • The psychological well-being gained from avoiding a stoma is a primary advantage of TAR.

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