Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3754
Peer-review started: November 4, 2021
First decision: December 27, 2021
Revised: January 8, 2022
Accepted: March 6, 2022
Article in press: March 6, 2022
Published online: April 26, 2022
Low anterior resection syndrome (LARS) seriously impairs the quality of life and mental status of rectal cancer patients after radical surgeries, but the underlying mechanism is not clearly understood.
More and more rectal cancer patients have benefited from integrative treatment of surgery and chemo-radiotherapy and their survival rates have been improved. Improving the quality of life and alleviating the defecation related symptom are becoming much more important.
The aim of this research was to fully assess anorectal function of rectal cancer patients perioperatively.
Mid-low rectal cancer patients were assessed with LARS score after surgery and three-dimensional high resolution anorectal manometry before and after surgery.
Twenty-four patients were included in this study. Their LARS scores decreased after surgery over time. The anorectal function detected by three-dimensional high resolution anorectal manometry after surgery was worse than that before surgery in all patients, especially in the neoadjuvant therapy group. The focal pressure defects of the anal canal and spastic peristaltic contractions from the new rectum to anus were detected in 70.8% and 45.8% of the patients, which were associated with higher LARS scores and rarely been reported before.
Anorectal function worsens after surgery in mid-low rectal cancer patients. The focal pressure defects of anal canal and spastic peristaltic contractions from the new rectum to anus postoperatively might be involved in the pathophysiological mechanisms of LARS.
More studies need to be done to confirm our finding that the anal focal pressure defects and spastic peristaltic contractions from the new rectum to anus might be involved in the pathophysiological mechanisms of LARS, and effective interventions should be explored to alleviate the suffering of rectal cancer patients after surgery.