[Functional sequelae after low anterior rectal surgery].
BACKGROUND
The treatment of colorectal cancer has changed radically in the last decades. Due to the great advances it is now often possible to subject patients to oncological radical treatments without applying to highly aggressive surgery, such as the Miles abdomino perineal resection, which requires a definitive colostomy. So nowadays we more and more apply to anterior resection of the rectum. Some recent studies about quality of life in patients who underwent anterior resection of the rectum focalized their attention on postoperative functional sequels. In particular incontinence, constipation, obstructed defecation and urgency are some of the symptoms which define the anterior resection syndrome, which can be efficiently treated by electrostimulation and biofeedback.


METHODS
A prospective study on 61 patients who underwent between 2002 and 2007 anterior resection of the rectum with total mesorectal excision for adenocarcinoma, has shown symptoms of anterior resection syndrome in 14 patients. Succeeding treatment with sphincter electrostimulation and biofeedback has shown improvement in all patients and complete resolution of the anterior resection syndrome in 10 patients who showed a great compliance and a steady improvement on quality of life.


CONCLUSIONS
Rehabilitative treatment with electrostimulation and biofeedback can sensibly reduce symptoms of anterior resection syndrome. An accurate manometric functional assessment is necessary before starting treatment with electrostimulation and biofeedback.
Istituto di Patologia Chirurgica, AOU, Sassari, Italy. carlo.pala@tiscali.it
Carlo
C
Pala
Fernando
F
Serventi
Panagiotis
P
Paliogiannis
Emilio
E
Trignano
Federico
F
Attene
Fabrizio
F
Scognamillo
Mario
M
Trignano
D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D001676:Biofeedback, Psychology; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods; D004599:Electric Stimulation Therapy; D005242:Fecal Incontinence / Q000209:etiology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D012002:Rectal Diseases / Q000209:etiology* / Q000534:rehabilitation*; D012004:Rectal Neoplasms / Q000601:surgery*; D013577:Syndrome