Early and Late Functional Outcomes of Anal Sphincter-Sparing Procedures With Total Mesorectal Excision for Anorectal Adenocarcinoma

Autor: Osama Eldamshety, Sherif Kotb, Ashraf Khater, Waleed Elnahas, Sameh Roshdy, Mohamed S. Zahi, Hend M.H. Rashed Elkalla, Omar Farouk, Ahmed Senbel, Adel Fathi, Emad-Eldeen Hamed, Khaled Abdelwahab, Islam A. Elzahby, Ahmed abdallah, Mahmoud Abdelaziz, Emanuele Lezoche
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Annals of Coloproctology, Vol 36, Iss 3, Pp 148-154 (2020)
Druh dokumentu: article
ISSN: 2287-9714
2287-9722
DOI: 10.3393/ac.2018.07.19
Popis: Purpose The study aims to assess the functional outcome of anal sphincter-sparing procedures (SSP) with total mesorectal excision (TME) for anorectal adenocarcinoma. Methods In a multicentric, prospective, single-group study in the period between December 2012 and November 2017, 93 patients presented with anorectal adenocarcinoma were included in the study. Sixty-nine patients underwent SSP with TME. SSP included the combined approach of transabdominal TME with intersphincteric resection (ISR) or transanal transabdominal TME. Using the per anal examination scoring system (PASS), postoperative anal function was assessed after 1 year. Results Bowel motility time was 50±19 hours. The time needed for narcotic analgesia was 54±18.8 hours. Mean hospital stay was 15.4±10.25 days. Incidence of evident fecal incontinence after ISR is 10.6% (7 of 67 cases). The PASS findings of 69 cases are as follows: extremely hypotonic 8.6% (6 cases), slightly hypotonic 26.1% (18 cases), normal tone 58% (40 cases), slightly stenotic 3 cases (4.3%), or occluded 2.9% (2 cases). Urinary dysfunction occurred in 1 case (1.4%). Temporary diversion was performed in 61 patients (87.1%). Conclusion Sphincter preservation with TME for anorectal adenocarcinoma helps avoid permanent stoma and provides reasonable functional outcomes. PASS is a new application for postoperative assessment of anal function.
Databáze: Directory of Open Access Journals
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