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Techniques in Coloproctology

, Volume 22, Issue 3, pp 239–241 | Cite as

Teaching TransAnal Irrigation (TAI): why it is mandatory

  • G. Gallo
  • S. Graziani
  • A. Realis Luc
  • G. Clerico
  • M. Trompetto
Correspondence

Dear Sir,

After sphincter-saving surgery for low rectal cancer, low anterior resection syndrome (LARS) is unfortunately a common finding, affecting up to 60% of patients who have this type of surgery [1]. A validated 5-item questionnaire for assessing the degree of bowel dysfunction after low anterior resection was introduced in 2012 [2].

Among the current conservative treatment options to improve bowel function in patients complaining of LARS, transanal irrigation (TAI) can be an effective and definitive option [3]. Despite its good results, TAI is not completely safe and several cases of bowel perforation have been recorded over the years [4].

A 63-year-old female had low anterior resection with a temporary loop ileostomy at our institution. She had neoadjuvant and postoperative chemoradiotherapy for locally advanced low rectal cancer.

After ileostomy closure she complained of severe urgency, clustering, flatus and liquid stool incontinence with more than 7 bowel movements per day....

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the author.

Informed consent

Informed consent was obtained from the participant included in the study.

References

  1. 1.
    Ziv Y, Zbar A, Bar-Shavit Y, Igov I (2013) Low anterior resection syndrome (LARS): cause and effect and reconstructive considerations. Tech Coloproctol 17:151–162CrossRefPubMedGoogle Scholar
  2. 2.
    Emmertsen KJ, Laurberg S (2012) Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg 255:922–928CrossRefPubMedGoogle Scholar
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    Martellucci J (2016) Low anterior resection syndrome: a treatment algorithm. Dis Colon Rectum 59:79–82CrossRefPubMedGoogle Scholar
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    Christensen P, Krogh K, Perrouin-Verbe B et al (2016) Global audit on bowel perforations related to transanal irrigation. Tech Coloproctol 20:109–115CrossRefPubMedGoogle Scholar
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    Shandling BG, Gilmour GF (1987) The enema continence catheter in spina bifida: successful bowel management. J Pediatr Surg 22:271–273CrossRefPubMedGoogle Scholar
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    Juul T, Christensen P (2017) Prospective evaluation of transanal irrigation for fecal incontinence and constipation. Tech Coloproctol 21:363–371CrossRefPubMedGoogle Scholar
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    Emmanuel AV, Krogh K, Bazzocchi G et al (2013) Consensus review of best practice of transanal irrigation in adults. Spinal Cord 51:732–738CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • G. Gallo
    • 1
    • 2
  • S. Graziani
    • 1
  • A. Realis Luc
    • 1
  • G. Clerico
    • 1
  • M. Trompetto
    • 1
  1. 1.Department of Colorectal SurgeryS. Rita ClinicVercelliItaly
  2. 2.Department of Medical and Surgical SciencesUniversity of CatanzaroCatanzaroItaly

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