Document Detail


Neurophysiologic investigation of anal function following double stapling anastomosis.
MedLine Citation:
PMID:  20689294     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM: Manual dilatation of the anal sphincter and transanal introduction of the circular stapling device are required for intraluminal stapling anastomosis. This procedure has been regarded as one of the causes of postoperative evacuatory disorder in low anterior resection. However, there has been no evidence of this matter. Therefore, we conducted this study to clarify the impact of the procedure of stapling anastomosis on postoperative anal function.
METHODS: Twenty-five cases with sigmoid colon cancer underwent potentially curative sigmoid colectomy with stapling anastomosis (ST group) and 20 cases with hand-sewn anastomosis (non-ST group). The patients were questioned regarding the daily frequency of bowel movement, the presence of urgency and soiling, and Wexner's incontinence score. Anorectal manomatry and pudendal nerve terminal motor latency were also evaluated. The patients' questionnaire and physiologic examinations were prospectively obtained before, and 1 and 6 months after the operation.
RESULTS: Postoperative bowel habit was graded as satisfied in 92% (23/25 patients) in the ST group and 90% (18/20 patients) in the non-ST group. There was no significant difference between the 2 groups in terms of presence of fecal incontinence, discrimination of gas and stool, and daily frequency of bowel movement. In anal manometry, there was no significant difference between the 2 groups regarding the resting and squeezing anal canal sphincter pressures at 1 and 6 months postoperatively. Pudendal nerve terminal motor latency showed their latency from 2.0 to 2.5 ms throughout the periods, and there was no difference between the 2 groups before, and 1 and 6 months after the operation.
CONCLUSION: Stapling anastomosis does not affect anal function in the early postoperative period.
Authors:
Hiroyoshi Matsuoka; Tadahiko Masaki; Takaaki Kobayashi; Kazunori Sato; Toshiyuki Mori; Masanori Sugiyama; Yutaka Atomi
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-08-03
Journal Detail:
Title:  Digestive surgery     Volume:  27     ISSN:  1421-9883     ISO Abbreviation:  Dig Surg     Publication Date:  2010  
Date Detail:
Created Date:  2010-08-27     Completed Date:  2010-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501808     Medline TA:  Dig Surg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  320-3     Citation Subset:  IM    
Copyright Information:
Copyright 2010 S. Karger AG, Basel.
Affiliation:
Department of Surgery, Kyorin University, School of Medicine, Mitaka, Tokyo, Japan. hmatsu@ks.kyorin-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Anal Canal / innervation*,  physiopathology
Anastomosis, Surgical / adverse effects,  methods*
Cohort Studies
Colectomy / adverse effects,  methods
Fecal Incontinence / etiology*,  physiopathology
Female
Follow-Up Studies
Humans
Male
Manometry
Middle Aged
Neurophysiology
Postoperative Complications / physiopathology
Retrospective Studies
Risk Assessment
Sigmoid Neoplasms / pathology,  surgery*
Statistics, Nonparametric
Surgical Stapling / adverse effects,  methods*
Suture Techniques
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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