Influence of different sphincter-preserving surgeries on postoperative defecation function.
10.3760/cma.j.cn441530-20220321-00108
- Author:
Sen HOU
1
;
Ying Jiang YE
1
Author Information
1. Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing 100044, China Laboratory of Surgical Oncology, Peking University People's Hospital, Beijing 100044, China Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People's Hospital, Beijing 100044, China.
- Publication Type:Journal Article
- Keywords:
Defecation function;
Rectal neoplasms, low;
Sphincter-preserving surgery
- MeSH:
Anal Canal/surgery*;
Anastomosis, Surgical/adverse effects*;
Defecation;
Fecal Incontinence/etiology*;
Humans;
Postoperative Complications/epidemiology*;
Rectal Neoplasms/surgery*
- From:
Chinese Journal of Gastrointestinal Surgery
2022;25(6):482-486
- CountryChina
- Language:Chinese
-
Abstract:
Advances in surgical techniques and treatment concept have allowed more patients with low rectal cancer to preserve sphincter without sacrificing survival benefit. However, postoperative dysfunctions such as fecal incontinence, frequency, urgency, and clustering often occur in patients with low rectal cancer. The main surgical procedures for low rectal cancer include low anterior rectum resection (LAR), intersphincteric resection (ISR), coloanal anastomosis (Parks) and so on. The incidence of major LARS after LAR is up to 84.6%. The postoperative function of ISR is even worse than LAR. Moreover, the greater the extent of resection ISR surgery, the worse the postoperative function. There are few studies on the function of Parks procedure. Current evidence suggests that the short-term function of Parks procedure is inferior to LAR, but function can gradually recovered over time. Colorectal surgeons have attempted to improve postoperative defecation by modifying bowel reconstructions. Current evidence suggests that J pouch or end-to-side anastomosis during LAR does not reduce the incidence of defecation disorders. Pouch reconstruction during ISR cannot reduce the incidence of severe LARS either. In general, the protection of postoperative defecation function in patients with low rectal cancer still has a long way to go.
