Original scientific paper

https://doi.org/10.20471/acc.2020.59.04.17

Correlation Between the Level of Colorectal Anastomosis and Anorectal Function

Branko Bakula orcid.org/0000-0001-6981-7877 ; Department of Abdominal Surgery, Sveti Duh University Hospital, Zagreb, Croatia
Žarko Rašić ; Department of Abdominal Surgery, Sveti Duh University Hospital, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Dragan Jurčić ; Department of Gastroenterology, Sveti Duh University Hospital, Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Marko Lucijanić orcid.org/0000-0002-1372-2040 ; Department of Hematology, Dubrava University Hospital, Zagreb, Croatia
Fran Rašić orcid.org/0000-0002-4398-7568 ; School of Medicine, University of Zagreb, Zagreb, Croatia

Abstract

Anterior rectal resection is a standard surgical procedure for treating carcinomas
of rectum and distal sigmoid colon. In many cases of anterior rectal resection, postoperatively some
level of fecal incontinence may occur. The aim of our study was to evaluate the impact of the colorectal
anastomosis level on anorectal functional disorder. In our prospective study, the participants were patients
diagnosed with carcinoma of rectum or distal sigmoid colon. All patients underwent standard
open or laparoscopic anterior rectal resection. Six months after the surgery, the function of anorectum
was evaluated in all participants. Finally, 38 patients were analyzed, including 13/38 (34.2%) patients
with high rectal anastomosis, 11/38 (28.9%) with mid rectal anastomosis and 14/38 (36.8%) with low
rectal anastomosis. Patients with a lower level of anastomosis had a statistically significantly greater
number of stools, higher urgency and discrimination impairment, more pronounced solid, liquid and
gas incontinence, and greater need for diapers (p<0.05 all). Therefore, patients with lower anastomosis
had a statistically significant impairment of their quality of life and higher Wexner score (p<0.001 for
both analyses). Our study results suggested reduced neorectal capacity to be the main pathophysiological
factor for the development of postoperative anorectal function impairment.

Keywords

Anterior resection; Rectal cancer; Wexner incontinence score; Anorectal function

Hrčak ID:

254884

URI

https://hrcak.srce.hr/254884

Publication date:

1.12.2020.

Article data in other languages: croatian

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