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Clinical and manometric evaluation of anorectal function following low anterior resection with low anastomotic line using an EEA™ stapler for rectal cancer
Authors:Dr. Shosaku Nakahara M.D.  Hideaki Itoh M.D.  Ryuichi Mibu M.D.  Shinichi Ikeda M.D.  Yoshihiro Oohata M.D.  Kamesaburo Kitano M.D.  Yoshihiko Nakamura M.D.
Affiliation:(1) Department of Surgery I, Kyushu University Faculty of Medicine, 3-1-1 Maidashi, 812 Fukuoka, Japan;(2) Department of Surgery, Kokura Municipal Hospital, Kitakyushu, Japan
Abstract:Anorectal function was evaluated in eight patients who had low anterior resection of the rectum with a low anastomotic line, using an EEA stapler, with determination of function based on periodic manometric studies and clinical symptoms. Immediately following surgery all patients suffered from frequent bowel actions and soiling. These symptoms improved with time and most patients could enjoy almost normal daily life by the sixth postoperative month. One month after surgery, anal canal resting pressure and maximum squeeze pressure were significantly reduced and rectoanal inhibitory reflex was absent; neither showed a distinct tendency to improve thereafter. Rectal sensation and reservoir capacity, which also were seriously impaired, recovered satisfactorily by the time of the six-month examination. This suggests that an improvement of clinical symptoms following this operation is dependent upon the recovery of reservoir capacity and sensation of the neorectum, and that this operative procedure is a functionally acceptable option for low rectal cancer.
Keywords:Anorectal function  Incontinence  Soiling  Low anterior resection  Manometric study  Pressure profile  Rectoanal reflex  Rectal reservoir capacity  Rectal sensation
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