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Anorectal Function Recovery Curve of the Patients with Different Tumor Locations After Sphincter-Saving Resection for Low Rectal Cancer

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Abstract

The detailed process of anorectal function recovery of the patients after sphincter-saving resection is unclear. We aimed to achieve detailed anorectal function recovery data of the patients after sphincter-saving resection and explore the relationship between the two frequently used anorectal function evaluation methods. A total of 72 eligible cases who underwent the sphincter-saving resection were divided into 3 groups according to the distal tumor margin distance from the anal verge. “L” replaced the distance; group 1: L ≤ 4 cm, group 2: 4 cm < L ≤ 6 cm, group 3: below the peritoneal reflection L > 6 cm. The anorectal function recovery outcomes of the 3 groups before and after the operation were compared. According to Wexner scores, the patients could achieve a satisfactory anorectal function at 3 months after surgery in group 2 and group 3. The patients required 4–5 months after surgery to achieve a satisfactory anorectal function in group 1. According to the ARM, in group 1 to group 3, the time at which the patients’ ARP and MSP after surgery started to show no significant decreases (p > 0.05) compared with preoperative levels were 12 months, 6 months, and 3 months after surgery, respectively. By combining the two methods, although the patients’ ARM indexes did not reach preoperative level (p < 0.05) at 6 months, 9 months, and 3 months in group 1 and group 2, respectively, their Wexner score showed a satisfactory anorectal condition. To all patients, when their ARP and MSP were basically returned to preoperative levels (p > 0.05), their average Wexner score was ≤ 4 or so. According to different rectal tumor locations, we had drawn the different anorectal function recovery curves with time, which could provide a reference for many treatments, such as the time of ileostomy closure. And we found the two anorectal function evaluation methods were not completely identical.

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Authors and Affiliations

  1. The First Department of General Surgery, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China

    Xing Huang, Zhigang Xiao, Wei Yan, Si Chen, Weizhen Luo & Zhongcheng Huang

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  1. Xing Huang
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  2. Zhigang Xiao
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  3. Wei Yan
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  4. Si Chen
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  5. Weizhen Luo
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  6. Zhongcheng Huang
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Contributions

X H, Zc H, and Zg X contributed to the conception and design; Wz L performed the anorectal manometry (ARM); X H, W Y, and S C did the acquisition of data; X H drafted the article; X H and Zc H did the critical revision of the article.

Corresponding authors

Correspondence to Xing Huang or Zhongcheng Huang.

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Ethical approval for the study was obtained from the ethics committee of Hunan Provincial People’s Hospital, and informed consent from all individual participants included in the study were obtained.

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The authors declare that they have no conflict of interest.

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Huang, X., Xiao, Z., Yan, W. et al. Anorectal Function Recovery Curve of the Patients with Different Tumor Locations After Sphincter-Saving Resection for Low Rectal Cancer. Indian J Surg 82, 338–344 (2020). https://doi.org/10.1007/s12262-019-01958-5

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  • DOI: https://doi.org/10.1007/s12262-019-01958-5

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