Low Anterior Resection Syndrome

Document Type : Letter to the Editor

Author

Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

In recent two decades with improving pelvic dissection techniques the rate of sphincter saving procedures following rectal resections increased and this significantly reduce the number of patients with permanent ostomy. Reconstruction following rectal resection comprise colon in low anterior resection or small bowel pouch following total proctocolectomy in case of ulcerative colitis or polyposis. Maintaining gastrointestinal continuity is not obligatory associated with good functional result as up to 60% of sphincter saving patients report degrees of frequency, urgency and uncontrolled passage of feces or gas.(1) Theses symptoms consider as low anterior resection syndrome and the pathophysiology is related to Internal anal sphincter denervation or injury to the extrinsic nerves from spinal cord which mediate rectoanal inhibitory reflex. Poor compliance of neorectum and rectal volume loss are other explanation for this pathology. (2) Surgical attempts to reduce this pathology fail to maintain long term patient satisfaction and the result showed same patient satisfaction after one year.(3)

Keywords

References

  1. Temple LK, Bacik J, Savatta SG, Gottesman L, Paty PB, Weiser MR, et al. The Development of a Validated Instrument to Evaluate Bowel Function After Sphincter-Preserving Surgery for Rectal Cancer. Dis Colon Rectum. 2005;48(7):1353-65.
  2. Nguyen TH, Chokshi RV. Low Anterior Resection Syndrome. Curr Gastroenterol Rep. 2020; 22(10):48.
  3. Hüttner FJ, Tenckhoff S, Jensen K, Uhlmann L, Kulu Y, Büchler MW, et al. Meta-analysis of reconstruction techniques after low anterior resection for rectal cancer. Br J Surg. 2015;102(7):735-45
Iranian Journal of Colorectal Research
Volume 9, Issue 4
December 2021
Pages 176-176

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