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Evaluation of postoperative damage to anal sphincter/levator ani muscles with three-dimensional vector manometry after sphincter-preserving operation for rectal cancer.
J Am Coll Surg. 2009 Mar; 208(3):362-7.JA

Abstract

BACKGROUND

The aim of this study was to examine correlations between pressure profile of the anal canal and postoperative defecatory disorder after sphincter-preserving operation (SPO) for rectal cancer.

STUDY DESIGN

Using three-dimensional vector manometry, pressure profile and length of the anal canal were evaluated more than 1 year after SPO according to operation method and degree of postoperative defecatory function in 53 patients with rectal cancer.

RESULTS

Compared with high anterior resection as a control, the anal canal was shorter in operations with a pelvic floor maneuver, namely, low anterior resection, ultra-low anterior resection, and intersphincteric resection. Patients with postoperative defecatory disorder showed significantly shorter anal canal length than patients with fair function. Length of the circular high-pressure zone (> or = 20 mmHg) < 20 mm in the resting state was a strong predictor of severe postoperative defecatory malfunction, with Wexner score> or =10.

CONCLUSIONS

Operative maneuvers at the pelvic floor during SPO for rectal cancer may damage anal sphincter or levator ani muscles. The circular high-pressure zone can be measured only by three-dimensional manometry and may offer a useful indicator of sphincter damage after SPO for rectal cancer.

Authors+Show Affiliations

Department of Surgery, Teikyo University Chiba Medical Center, Ichihara City, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

19317997

Citation

Koda, Keiji, et al. "Evaluation of Postoperative Damage to Anal Sphincter/levator Ani Muscles With Three-dimensional Vector Manometry After Sphincter-preserving Operation for Rectal Cancer." Journal of the American College of Surgeons, vol. 208, no. 3, 2009, pp. 362-7.
Koda K, Yasuda H, Hirano A, et al. Evaluation of postoperative damage to anal sphincter/levator ani muscles with three-dimensional vector manometry after sphincter-preserving operation for rectal cancer. J Am Coll Surg. 2009;208(3):362-7.
Koda, K., Yasuda, H., Hirano, A., Kosugi, C., Suzuki, M., Yamazaki, M., Tezuka, T., Higuchi, R., Tsuchiya, H., & Saito, N. (2009). Evaluation of postoperative damage to anal sphincter/levator ani muscles with three-dimensional vector manometry after sphincter-preserving operation for rectal cancer. Journal of the American College of Surgeons, 208(3), 362-7. https://doi.org/10.1016/j.jamcollsurg.2008.10.035
Koda K, et al. Evaluation of Postoperative Damage to Anal Sphincter/levator Ani Muscles With Three-dimensional Vector Manometry After Sphincter-preserving Operation for Rectal Cancer. J Am Coll Surg. 2009;208(3):362-7. PubMed PMID: 19317997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of postoperative damage to anal sphincter/levator ani muscles with three-dimensional vector manometry after sphincter-preserving operation for rectal cancer. AU - Koda,Keiji, AU - Yasuda,Hideki, AU - Hirano,Atsushi, AU - Kosugi,Chihiro, AU - Suzuki,Masato, AU - Yamazaki,Masato, AU - Tezuka,Tohru, AU - Higuchi,Ryota, AU - Tsuchiya,Hironori, AU - Saito,Norio, Y1 - 2008/12/25/ PY - 2008/08/15/received PY - 2008/10/03/revised PY - 2008/10/29/accepted PY - 2009/3/26/entrez PY - 2009/3/26/pubmed PY - 2009/4/3/medline SP - 362 EP - 7 JF - Journal of the American College of Surgeons JO - J Am Coll Surg VL - 208 IS - 3 N2 - BACKGROUND: The aim of this study was to examine correlations between pressure profile of the anal canal and postoperative defecatory disorder after sphincter-preserving operation (SPO) for rectal cancer. STUDY DESIGN: Using three-dimensional vector manometry, pressure profile and length of the anal canal were evaluated more than 1 year after SPO according to operation method and degree of postoperative defecatory function in 53 patients with rectal cancer. RESULTS: Compared with high anterior resection as a control, the anal canal was shorter in operations with a pelvic floor maneuver, namely, low anterior resection, ultra-low anterior resection, and intersphincteric resection. Patients with postoperative defecatory disorder showed significantly shorter anal canal length than patients with fair function. Length of the circular high-pressure zone (> or = 20 mmHg) < 20 mm in the resting state was a strong predictor of severe postoperative defecatory malfunction, with Wexner score> or =10. CONCLUSIONS: Operative maneuvers at the pelvic floor during SPO for rectal cancer may damage anal sphincter or levator ani muscles. The circular high-pressure zone can be measured only by three-dimensional manometry and may offer a useful indicator of sphincter damage after SPO for rectal cancer. SN - 1879-1190 UR - https://www.unboundmedicine.com/medline/citation/19317997/Evaluation_of_postoperative_damage_to_anal_sphincter/levator_ani_muscles_with_three_dimensional_vector_manometry_after_sphincter_preserving_operation_for_rectal_cancer_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1072-7515(08)01549-4 DB - PRIME DP - Unbound Medicine ER -