PMID: 8951517Jan 1, 1996Paper

Anterior resection syndrome is secondary to sympathetic denervation

International Journal of Colorectal Disease
G N RaoG S Duthie

Abstract

The mechanism of faecal incontinence following low anterior resection (LAR) has been speculative and the role of disordered neorectal dynamics difficult to quantify. Using a new methodology which quantifies rectal response to rapid and ramp inflation, in combination with anal physiology, we have evaluated 25 LAR-7 with major incontinence and 5 with minor incontinence. The three groups had comparable age, duration post surgery and anastomotic distance from the puborectalis. The resting anal canal pressure (RAP) did not related to the anastomotic distance (R2 = 0.09). With the anastomosis at and below 3 cms from the puborectalis, the rectoanal inhibitory reflex (RAIR) was a sustained drop in the mid anal canal pressure, in contrast to the normal pattern of recovery above this level. Major incontinence was characterised by a subnormal anal defence, hypersensitive neorectal dynamics and high amplitude contractile wave while minor incontinence was characterised by a hypernormal anal defence and a lesser degree of neorectal hypersensitivity. The mathematical viscoelastic rectal model, defined an increasing longitudinal smooth muscle tone and a decreasing functional collagen with increasing severity of incontinence as well as a high a...Continue Reading

Citations

Jul 25, 2008·Langenbeck's Archives of Surgery·Andreas D RinkKarl-Heinz Vestweber
Feb 5, 2000·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·V SvobodaH Jung
Sep 29, 2009·Acta chirurgica Iugoslavica·A P ZbarV Singh
Jun 11, 2009·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·S DobrowolskiZ Sledziński
Nov 21, 2015·World Journal of Urology·Bernhard KissGeorge N Thalmann
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Feb 15, 2013·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Y ZivI Igov
Apr 9, 2005·Surgical Oncology Clinics of North America·Victor W Fazio, Alexander G Heriot
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