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Transanal Conformal Resection Is Associated with a Better Postoperative Anorectal Function Compared with Intersphincteric Resection for Low Rectal Cancer

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Abstract

As a new type of sphincter-saving resection aim to improve postoperative anorectal function for low rectal cancer, the anorectal function recovery outcomes after transanal conformal resection (TaCR) need further study. A total of 43 eligible cases who underwent TaCR or total intersphincteric resection (ISR) were divided into 2 groups. Group 1 included 21 cases who underwent total ISR; group 2 included 22 cases who underwent TaCR. The anorectal function recovery outcomes of the 2 groups before and after the operation were compared. According to Wexner scores: The patients required 6–7 months after surgery to achieve a satisfactory anorectal function in group 1, but the patients in group 2 only required 5–6 months. The recovery time of anorectal function in group 2 was shorter than that in group 1. According to the anorectal manometry (ARM): After 1 year of recovery, the patients’ anal resting pressure (ARP) still could not return to preoperative level in group 1. In group 2, the time at which the patients’ ARP after surgery started to show no significant decreases (p > 0.05) compared with preoperative levels was 12 months. The time at which the patients’ maximum squeeze pressure (MSP) after surgery started to show no significant decreases (p > 0.05) compared with preoperative levels was 9 months after surgery in both groups. Our data showed that TaCR was associated with a better postoperative anorectal function compared with total ISR. And we had drawn the anorectal function recovery curves with time for the patients who underwent total ISR or TaCR, respectively; it may provide reference for ileostomy closure and other interventions.

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Data Availability

The principal investigators will have access to the final trial database, which will be available on reasonable request. Participants’ personal information will be confidentially.

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Funding

Funding was provided by the Youth Science and Technology Talent Program of Hunan Provincial Science and Technology Department (2022RC1217), the Natural Science Foundation of Changsha City (kq2208110), and the Scientific Research Project of Hunan Provincial Health Commission (202204010021). (The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.)

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Authors and Affiliations

  1. The First Department of General Surgery (Department of Colorectal and Anal Surgery), Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), No. 61 Jiefang West Road, Changsha, Hunan, China

    Xing Huang, Zhigang Xiao & Zhongcheng Huang

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  1. Xing Huang
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  3. Zhongcheng Huang
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Contributions

X H contributed to the conception; X H contributed to the design; X H did the acquisition of data; X H did the quality control of data and algorithms; X H did the data analysis and interpretation; X H did the statistical analysis; X H edited the manuscript; Zg X and Zc H did the revision of the article.

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Correspondence to Xing Huang.

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Ethics Approval and Consent to Participate

The Ethics Committees of the Hunan Provincial People’s Hospital approved this study (number of the ethics approval: YF-201903863), and written informed consent about operative techniques and to the data-use agreement was obtained from all patients before surgery.

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Not applicable

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The authors declare no competing interests.

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Huang, X., Xiao, Z. & Huang, Z. Transanal Conformal Resection Is Associated with a Better Postoperative Anorectal Function Compared with Intersphincteric Resection for Low Rectal Cancer. Indian J Surg 85, 1409–1416 (2023). https://doi.org/10.1007/s12262-023-03767-3

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  • DOI: https://doi.org/10.1007/s12262-023-03767-3

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