title: [Anorectal disorders in the immediate and late postoperative period after transanal endoscopic microsurgery].
abstract: OBJECTIVE
  Transanal endoscopic microsurgery (TEM) is a new technique for local excision of benign and incipient malignant rectal lesions. This technique offers technological advantages over other procedures and is associated with lower morbidity and mortality. TEM involves prolonged dilatation of the anal sphincter with a large-diameter (4 cm) operating rectoscope. The aim of the present study was to assess the effects of TEM on anorectal function.
  
  
  METHODS
  All patients undergoing TEM were included. Continence was scored by a numeric scale and anorectal manometry before surgery and 3 weeks and 4 months after surgery. Variations in anal resting pressure, maximal anal resting pressure and the anal continence questionnaire were evaluated.
  
  
  RESULTS
  Sixty-eight patients underwent TEM between June 2004 and August 2006. Mean anal resting pressure (ARP) and maximal anal resting pressure (MARP) were significantly reduced at 3 weeks after surgery (ARP/MARP before surgery: 38.89/126.28; 3 weeks after surgery: 26.61/104.75). No significant change was found in the mean continence score. No association was found between variation in pressures and operating time.
  
  
  CONCLUSIONS
  TEM produced statistically significant alterations in anorectal physiology studies which returned to normal at 4 months. The technique did not affect continence scores in the immediate or late postoperative period and consequently can be considered a safe procedure that does not produce significant alterations in anorectal function.
authors.affiliation: Servicio de Cirugía General, Corporació Sanitària Parc Taulí, Sabadell, Barcelona, España. Lmora@cspt.es
authors.forename: Laura
authors.initials: L
authors.lastname: Mora López
authors.forename: Javier
authors.initials: J
authors.lastname: Serra Aracil
authors.forename: Pere
authors.initials: P
authors.lastname: Rebasa Cladera
authors.forename: Valentí
authors.initials: V
authors.lastname: Puig Divi
authors.forename: Judith
authors.initials: J
authors.lastname: Hermoso Bosch
authors.forename: Jordi
authors.initials: J
authors.lastname: Bombardo Junca
authors.forename: Manuel
authors.initials: M
authors.lastname: Alcántara Moral
authors.forename: Rubén
authors.initials: R
authors.lastname: Hernando Tavira
authors.forename: Isidro
authors.initials: I
authors.lastname: Ayguavives Garnica
authors.forename: Salvador
authors.initials: S
authors.lastname: Navarro Soto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000502:physiology*; D003627:Data Interpretation, Statistical; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008365:Manometry; D008866:Microsurgery; D008875:Middle Aged; D011183:Postoperative Complications; D020700:Proctoscopes; D011351:Proctoscopy; D012004:Rectal Neoplasms / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors