Anorectal dysfunction in patients with mid-low rectal cancer after surgery: A pilot study with three-dimensional high-resolution manometry

Table 1 General information of patients with mid-low rectal cancer

Item		Number
Sex	Male	14
	Female	10
cTNM stage	T2	8
	T3	15
	T4	1
	N0	11
	N1	11
	N2	2
Preoperative neoadjuvant therapy	Yes	18
	No (surgery only)	6
Anterior resection	Dixon	22
	Intersphincteric resection	2
Diverting stoma	Yes	18
	No	6
Postoperative chemotherapy		5

Table 2 Low anterior resection syndrome score in patients with mid-low rectal cancer at 3 and 6 mo after surgery

Item (scale point)	3 mo after surgery, n (%)	6 mo after surgery, n (%)	P value
Frequency of uncontrolled intestinal flatus			0.005
No, never (0)	4 (16.7)	10 (41.7)
Yes, less than once per wk (4)	1 (4.2)	8 (33.3)
Yes, at least once per wk (7)	19 (79.2)	6 (25.0)
Frequency of uncontrolled intestinal fluid			0.003
No, never (0)	5 (20.8)	13 (54.2)
Yes, less than once per wk (3)	8 (33.3)	8 (33.3)
Yes, at least once per wk (3)	11 (45.8)	3 (12.5)
Bowel frequency			0.037
> 7 times/d (4)	7 (29.2)	2 (8.3)
4-7 times/d (2)	16 (66.7)	18 (75.0)
1-3 times/d (0)	1 (4.2)	4 (16.7)
Less than once per day (5)	0 (0)	0 (0)
Clustering			0.500
No, never (0)	1 (4.2)	3 (12.5)
Yes, less than once per wk (9)	0 (0)	0 (0)
Yes, at least once per wk (11)	23 (95.8)	21 (87.5)
Urgency			0.040
No, never (0)	2 (8.3)	3 (12.5)
Yes, less than once per wk (11)	1 (4.2)	8 (33.3)
Yes, at least once per wk (16)	21 (87.5)	13 (54.2)
LARS score1	39 (1.5)	31 (7.5)	< 0.001
No LARS (0-20)	3 (12.5)	4 (16.7)
Minor LARS (21-29)	1 (4.2)	6 (25.0)
Major LARS (30-42)	20 (83.3)	14 (58.3)

¹LARS score is expressed as the median (interquartile range) and a Wilcoxon signed-ranks test was used to identify a significant difference between 3 mo and 6 mo after surgery.

LARS: Low anterior resection syndrome.

Table 3 Comparison of anorectal functions detected by three-dimensional high-resolution anorectal manometry before and after surgery

Parameter	Total (n = 24)		Surgery only group (n = 6)		Neoadjuvant group (n = 18)
	Before surgery	After surgery	Before surgery	After surgery	Before surgery	After surgery
Length of high pressure zone of anal sphincter (cm)	3.6 ± 0.7	2.8 ± 1.2a	3.6 ± 0.5	3.6 ± 1.1	3.6 ± 0.7	2.6 ± 1.2a
Mean resting pressure of the anus (mmHg)	107.6 ± 32.3	67.6 ± 28.1a	102.9 ± 38.9	75.2 ± 37.2a	109.2 ± 30.9	65.1 ± 25.2a
Maximal squeeze pressure (mmHg)	259 ± 80.0	207.8 ± 63.3a	274.9 ± 109.6	249.8 ± 89.7	253.7 ± 70.8	193.8 ± 47.2a
First perception of rectal filling volume (mL)	35.6 ± 19.7	39.2 ± 25.8 (n = 12)	20.0 ± 14.1	25.0 ± 7.1 (n = 2)	43.0 ± 27.5	42.0 ± 27.4 (n = 10)
Urgency to defecate volume (mL)	60.0 ± 24.3	51.4 ± 31.9 (n = 7)	35.0 ± 21.2	35.0 ± 7.1 (n = 2)	66.0 ± 18.2	58.0 ± 36.3 (n = 5)
Maximal tolerable volume (mL)	112.1 ± 42.1	71.4 ± 21.2 (n = 7)	123.3 ± 64.3	60.0 ± 26.5 (n = 3)	110.0 ± 11.6	80.0 ± 14.1 (n = 4)

^aP < 0.05.

Data are expressed as the mean ± SD. A paired t-test was used to compare the data before vs after surgery. The numbers of patients who acquired the first perception of rectal filling volume, urgency to defecate volume, and maximal tolerable volume after surgery are listed in brackets, and those data were not compared for the difference between before and after surgery.