Anal Sphincteric Function Assessment of Intersphincteric Resection for Low Rectal Cancer by Vectorial Manometry_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CONG Jinchun , DAI Xianwei , ZHANG Hong , CHEN Chunsheng , LIU Enqing

Department of Anorectal Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, China;

Corresponding author：

Keywords：

Low rectal cancer; Intersphincteric resection; Vectorial manometry of rectum-anal canal

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To assess the anal sphincteric function after intersphincteric resection for low rectal cancer by vectorial manometry.
Methods 　Maximal anal pressure, vector volume, vector symmetric index and rectal anal inhibitory reflex were assessed in 16 patients underwent intersphincteric resection for low rectal cancer from 1999 to 2006. Thirty patients with low anterior resection for rectal cancer and another 30 healthy individuals were selected as control.
Results 　The patients in intersphincteric resection group were subdivided into soiling group and defecation function good group. Maximal pressure, vector volume and vector symmetric index of the patients in soiling group and defecation function good group were significantly lower than those of the healthy and low anterior resection controls (P＜0.001). The maximal systole pressure, systole vector volume and vector symmetric index in soiling group were significantly lower than those in function good group (P＜0.001). The 25.0% patients in intersphincteric resection group had rectal anal inhibitory reflex， was significantly lower than that of the low anterior resection control group (93.3%, P＜0.001).
Conclusion 　The maximal pressure and vector volume are compromised in patients underwent intersphincteric resection . The vectorial manometry can be an objective comprehensive tool for the evaluation of anal sphincter function in patients with intersphincteric resection.

Citation： CONG Jinchun,DAI Xianwei,ZHANG Hong,CHEN Chunsheng,LIU Enqing. Anal Sphincteric Function Assessment of Intersphincteric Resection for Low Rectal Cancer by Vectorial Manometry. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2007, 14(6): 634-638. doi: Copy

1.	刘宝善.直肠癌超低位切除的理论基础与临床效果 [Ｊ]. 中国普外基础与临床杂志, 2001; 8（1）∶38.
2.	Braun J, Treutner KH, Winkeltau G, et al. Results of intersphincteric resection of the rectum with direct coloanal anastomosis for rectal carcinoma [Ｊ]. Am J Surg, 1992; 163(4)∶407.
3.	Schiessel R, Karner-Hanusch J, Herbst F, et al. Intersphincteric resection for low rectal tumours [Ｊ]. Br J Surg, 1994; 81(9)∶1376.
4.	Rullier E, Zerbib F, Laurent C, et al. Intersphincteric resection with excision of internal anal sphincter for conservative treatment of very low rectal cancer [Ｊ]. Dis Colon Rectum, 1999; 42(9)∶1168.
5.	Saito N, Ono M, Sugito M, et al. Early results of intersphincteric resection for patients with very low rectal cancer: an active approach to avoid a permanent colostomy [Ｊ]. Dis Colon Rectum, 2004; 47(4)∶459.
6.	Williams NS, Patel J, George BD, et al. Development of an electrically stimulated neoanal sphincter [Ｊ]. Lancet, 1991; 338(8776)∶1166.
7.	王峰, 韩方海, 马百柱, 等. 中低位直肠癌保留肛门括约肌手术与经腹会阴切除术的比较分析 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(2)∶211.
8.	Teramoto T, Watanabe M, Kitajima M. Per anum intersphincteric rectal dissection with direct coloanal anastomosis for lower rectal cancer: the ultimate sphincter-preserving operation [Ｊ]. Dis Colon Rectum, 1997; 40(10 Suppl)∶S43.
9.	刘连杰，喻德洪. 肛管直肠测压的临床研究 [Ｊ]. 中国普外基础与临床杂志, 2001; 8(1)∶59.
10.	王伟, 袁正伟, 王维林. 三维向量测压在无肛术后患儿排便功能随访与康复治疗中的应用 [Ｊ]. 中国医科大学学报， 2005； 34(1)∶71.
11.	Sangwan YP, Solla JA. Internal anal sphincter: advances and insights [Ｊ]. Dis Colon Rectum, 1998; 41(10)∶1297.
12.	van Duijvendijk P, Slors F, Taat CW, et al. A prospective evaluation of anorectal function after total mesorectal excision in patients with a rectal carcinoma [Ｊ]. Surgery, 2003; 133(1)∶56.
13.	Benninga MA, Wijers OB, van der Hoeven CW, et al. Manometry, profilometry, and endosonography: normal physiology and anatomy of the anal canal in healthy children [Ｊ]. J Pediatr Gastroenterol Nutr, 1994; 18(1)∶68.
14.	Perry RE, Blatchford GJ, Christensen MA, et al. Manometric diagnosis of anal sphincter injuries [Ｊ]. Am J Surg, 1990; 159(1)∶112.
15.	Ho YH, Tan M, Leong A, et al. Anal pressures impaired by stapler insertion during colorectal anastomosis: a randomized, controlled trial [Ｊ]. Dis Colon Rectum, 1999; 42(1)∶89.
16.	王伟, 李正. Lynn 法治疗短段型先天性巨结肠疗效观察 [Ｊ]. 中华小儿外科杂志, 1992; 13(6)∶345.
17.	丛进春, 张宏, 陈春生, 等. 生物反馈训练可以提高超低位直肠癌内括约肌切除术后的排便功能 [Ｊ]. 世界华人消化杂志, 2006; 14(25)∶2566.
18.	Matsushita K, Yamada K, Sameshima T, et al. Prediction of incontinence following low anterior resection for rectal carcinoma [Ｊ]. Dis Colon Rectum, 1997; 40(5)∶575.
19.	Shibata D, Guillem JG, Lanouette N, et al. Functional and quality-of-life outcomes in patients with rectal cancer after combined modality therapy, intraoperative radiation therapy, and sphincter preservation [Ｊ]. Dis Colon Rectum, 2000; 43(6)∶752.
20.	Kohler A, Athanasiadis S, Ommer A, et al. Long-term results of low anterior resection with intersphincteric anastomosis in carcinoma of the lower one-third of the rectum: analysis of 31 patients [Ｊ]. Dis Colon Rectum, 2000; 43(6)∶843.
21.	Schiessel R, Novi G, Holzer B, et al. Technique and long-term results of intersphincteric resection for low rectal cancer [Ｊ]. Dis Colon Rectum, 2005; 48(10)∶1858.

1. 　刘宝善.直肠癌超低位切除的理论基础与临床效果 [Ｊ]. 中国普外基础与临床杂志, 2001; 8（1）∶38.
2. 　Braun J, Treutner KH, Winkeltau G, et al. Results of intersphincteric resection of the rectum with direct coloanal anastomosis for rectal carcinoma [Ｊ]. Am J Surg, 1992; 163(4)∶407.
3. 　Schiessel R, Karner-Hanusch J, Herbst F, et al. Intersphincteric resection for low rectal tumours [Ｊ]. Br J Surg, 1994; 81(9)∶1376.
4. 　Rullier E, Zerbib F, Laurent C, et al. Intersphincteric resection with excision of internal anal sphincter for conservative treatment of very low rectal cancer [Ｊ]. Dis Colon Rectum, 1999; 42(9)∶1168.
5. 　Saito N, Ono M, Sugito M, et al. Early results of intersphincteric resection for patients with very low rectal cancer: an active approach to avoid a permanent colostomy [Ｊ]. Dis Colon Rectum, 2004; 47(4)∶459.
6. 　Williams NS, Patel J, George BD, et al. Development of an electrically stimulated neoanal sphincter [Ｊ]. Lancet, 1991; 338(8776)∶1166.
7. 　王峰, 韩方海, 马百柱, 等. 中低位直肠癌保留肛门括约肌手术与经腹会阴切除术的比较分析 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(2)∶211.
8. 　Teramoto T, Watanabe M, Kitajima M. Per anum intersphincteric rectal dissection with direct coloanal anastomosis for lower rectal cancer: the ultimate sphincter-preserving operation [Ｊ]. Dis Colon Rectum, 1997; 40(10 Suppl)∶S43.
9. 　刘连杰，喻德洪. 肛管直肠测压的临床研究 [Ｊ]. 中国普外基础与临床杂志, 2001; 8(1)∶59.
10. 　王伟, 袁正伟, 王维林. 三维向量测压在无肛术后患儿排便功能随访与康复治疗中的应用 [Ｊ]. 中国医科大学学报， 2005； 34(1)∶71.
11. 　Sangwan YP, Solla JA. Internal anal sphincter: advances and insights [Ｊ]. Dis Colon Rectum, 1998; 41(10)∶1297.
12. 　van Duijvendijk P, Slors F, Taat CW, et al. A prospective evaluation of anorectal function after total mesorectal excision in patients with a rectal carcinoma [Ｊ]. Surgery, 2003; 133(1)∶56.
13. 　Benninga MA, Wijers OB, van der Hoeven CW, et al. Manometry, profilometry, and endosonography: normal physiology and anatomy of the anal canal in healthy children [Ｊ]. J Pediatr Gastroenterol Nutr, 1994; 18(1)∶68.
14. 　Perry RE, Blatchford GJ, Christensen MA, et al. Manometric diagnosis of anal sphincter injuries [Ｊ]. Am J Surg, 1990; 159(1)∶112.
15. 　Ho YH, Tan M, Leong A, et al. Anal pressures impaired by stapler insertion during colorectal anastomosis: a randomized, controlled trial [Ｊ]. Dis Colon Rectum, 1999; 42(1)∶89.
16. 　王伟, 李正. Lynn 法治疗短段型先天性巨结肠疗效观察 [Ｊ]. 中华小儿外科杂志, 1992; 13(6)∶345.
17. 　丛进春, 张宏, 陈春生, 等. 生物反馈训练可以提高超低位直肠癌内括约肌切除术后的排便功能 [Ｊ]. 世界华人消化杂志, 2006; 14(25)∶2566.
18. 　Matsushita K, Yamada K, Sameshima T, et al. Prediction of incontinence following low anterior resection for rectal carcinoma [Ｊ]. Dis Colon Rectum, 1997; 40(5)∶575.
19. 　Shibata D, Guillem JG, Lanouette N, et al. Functional and quality-of-life outcomes in patients with rectal cancer after combined modality therapy, intraoperative radiation therapy, and sphincter preservation [Ｊ]. Dis Colon Rectum, 2000; 43(6)∶752.
20. 　Kohler A, Athanasiadis S, Ommer A, et al. Long-term results of low anterior resection with intersphincteric anastomosis in carcinoma of the lower one-third of the rectum: analysis of 31 patients [Ｊ]. Dis Colon Rectum, 2000; 43(6)∶843.
21. 　Schiessel R, Novi G, Holzer B, et al. Technique and long-term results of intersphincteric resection for low rectal cancer [Ｊ]. Dis Colon Rectum, 2005; 48(10)∶1858.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Anal Sphincteric Function Assessment of Intersphincteric Resection for Low Rectal Cancer by Vectorial Manometry

Abstract Full text Figures/Tables Video References Cited by

Format

Content