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The effects of the posterior sagittal approach on rectal function (experimental study)
1Department of Surgery, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, NY.
Journal of Pediatric Surgery
|June 1, 1993
Summary
The posterior sagittal transsphincteric approach minimally impacts bowel control. Perirectal dissection caused significant issues, while the posterior sagittal approach showed no adverse effects on rectal function or fecal continence.
Area of Science:
- Colorectal surgery
- Surgical outcomes
- Anorectal function
Background:
- The posterior sagittal transsphincteric approach is used for anorectal malformations and acquired conditions.
- Clinical data suggest preserved voluntary muscle function post-surgery, but objective functional evaluations are lacking.
Purpose of the Study:
- To experimentally evaluate rectal function and fecal continence after the posterior sagittal transsphincteric approach.
- To compare the effects of different surgical techniques on anorectal function.
Main Methods:
- Sixteen dogs were divided into four groups based on surgical intervention: posterior sagittal approach alone, with rectotomy, with perirectal dissection, or perirectal dissection alone.
- Clinical and manometric assessments were performed preoperatively and up to 12 weeks postoperatively.
Main Results:
- Perirectal dissection, with or without the posterior sagittal incision, led to severe alterations in bowel control and manometric parameters.
- The posterior sagittal approach, with or without rectotomy, resulted in minimal to no changes in bowel function and rectal manometry.
Conclusions:
- The posterior sagittal approach does not interfere with the function of the sphincteric mechanism.
- Experimental findings support clinical observations regarding the safety of the posterior sagittal approach for anorectal function.