Preoperative anal function assessment in sphincter-preserving surgery for rectal cancer: clinical significance and strategies
10.3760/cma.j.cn441530-20250410-00152
- VernacularTitle:直肠癌保肛手术前肛门功能评估策略及其临床意义
- Author:
Fan LIU
1
;
Yingjiang YE
1
Author Information
1. 北京大学人民医院胃肠外科 北京大学人民医院外科肿瘤研究室 北京市结直肠癌诊疗研究重点实验室，北京 100044
- Publication Type:Journal Article
- Keywords:
Rectal neoplasms;
Sphincter-preserving surgery;
Preoperative assessment;
Anal function
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(6):609-614
- CountryChina
- Language:Chinese
-
Abstract:
Sphincter-preserving surgery has become the mainstream approach for mid-to-low rectal cancer, yet postoperative anal dysfunction (low anterior resection syndrome, LARS) occurs in 30%-50% of patients, significantly impacting quality of life. This review systematically elaborates the clinical value of preoperative anal function assessment (mainly digital rectal examination), proposing a multidimensional evaluation system integrating anatomical (including high-resolution anorectal MRI, 3D transrectal ultrasound and dynamic contrast-enhanced ultrasound), physiological (anorectal amnometry and anal electromyography), and neurological assessments (including Parks scale, Wexner score, MSK-BFI scale and LARS score), alongside innovative strategies such as artificial intelligence and gut microbiome analysis. We advocate incorporating preoperative functional assessment into quality control standards for sphincter preservation, promoting a paradigm shift from "anatomical preservation" to "functional preservation".
