Browse

Anal sphincter asymmetry in anal incontinence after restorative proctectomy for rectal cancer

Cited 7 time in Web of Science Cited 10 time in Scopus
Authors
Kang, Sung-Bum; Kim, Nayoung; Lee, Kyoung-Ho; Kim, Young-Hoon; Kim, Jee Hyun; Kim, Jae-Sung
Issue Date
2008-04-30
Publisher
Springer Verlag
Citation
World J Surg. 2008 Sep;32(9):2083-8.
Keywords
AdultAgedAged, 80 and overAnal Canal/physiopathology/*surgery/ultrasonographyChi-Square DistributionEndosonographyFecal Incontinence/*etiology/physiopathology/ultrasonographyFemaleHumansIatrogenic DiseaseLogistic ModelsMaleManometryMiddle Aged*Proctocolectomy, RestorativeRectal Neoplasms/*surgeryTreatment Outcome
Abstract
PURPOSE: The morphology and physiology of the anorectum can be altered after restorative proctectomy, which may result in anal incontinence. Thus far, there have been few reports regarding the specific characteristics and management of anal incontinence after rectal cancer surgery. We attempted to determine the characteristics of anorectum in anal incontinence after restorative proctectomy. METHODS: We compared the clinical and physiologic factors between consecutive 138 patients with continence and 48 with iatrogenic anal incontinence at 1 year after rectal cancer resection. This study excluded patients at less than 1 year after operation or ileostomy takedown. RESULTS: The two groups were comparable with regard to age, sex ratio, radiotherapy, and complication rate. The percentages of asymmetry of the resting and squeeze sphincter were significantly higher in the anal incontinence group (37.2 +/- 9.3% vs 32.5 +/- 6.7%, P = 0.01; 32.4 +/- 7.8% vs 28.3 +/- 6.3%, P = 0.011). High-pressure zone length, mean resting vector volume, and rectal compliance were not less in the anal incontinence group than in the continence group. In multivariate analysis of manometric variables, the percentages of asymmetry of the resting and squeeze were independent factors associated with anal incontinence (P < 0.05). The mean thickness of the anal cushion and internal anal sphincter did not significantly differ between the anal incontinence and continence groups. CONCLUSION: Sphincter asymmetry is one of the hallmark characteristics of iatrogenic anal incontinence patients after proctectomy, which suggests that anal canal symmetry may be a beneficial factor with regard to anal continence.
ISSN
0364-2313 (Print)
0364-2313 (Linking)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18443852

http://www.springerlink.com/content/tl026p754343151m/fulltext.pdf

http://hdl.handle.net/10371/46299
DOI
https://doi.org/10.1007/s00268-008-9602-0
Files in This Item:
There are no files associated with this item.
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Radiation Oncology (방사선종양학전공)Journal Papers (저널논문_방사선종양학전공)
  • mendeley

Items in S-Space are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse