title: A hyperactive postprandial response in the neorectum--the clue to low anterior resection syndrome after total mesorectal excision surgery?
abstract: OBJECTIVE
  To investigate neorectal properties regarding biomechanical, sensory and postprandial response in patients after total mesorectal excision without neoadjuvant radiotherapy in groups of no low anterior resection syndrome (LARS) patients and major LARS patients.
  
  
  METHODS
  Patients without LARS (n = 9) and patients with major LARS (n = 23) were investigated by multimodal rectal stimulation and standard anorectal physiological tests, and results were compared.
  
  
  RESULTS
  Patients with major LARS had an increased postprandial response with a significant increase in pressure in the neorectum after a meal compared with patients without LARS (P = 0.017). No biomechanical differences could be detected.
  
  
  CONCLUSIONS
  Low anterior resection syndrome seems to be caused by physiological changes due to neural damage more than structural changes in the ano-neorectum.
authors.affiliation: Surgical Research Unit, Colorectal Surgical Department, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: K J
authors.initials: KJ
authors.lastname: Emmertsen
authors.forename: S
authors.initials: S
authors.lastname: Bregendahl
authors.forename: J
authors.initials: J
authors.lastname: Fassov
authors.forename: K
authors.initials: K
authors.lastname: Krogh
authors.forename: S
authors.initials: S
authors.lastname: Laurberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D005242:Fecal Incontinence / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009119:Muscle Contraction; D009130:Muscle, Smooth / Q000503:physiopathology; D011183:Postoperative Complications / Q000503:physiopathology*; D019518:Postprandial Period; D011312:Pressure; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000503:physiopathology*; D012189:Retrospective Studies; D012677:Sensation; D013577:Syndrome
keywords: LARS; Rectal cancer; anal manometry; multimodal rectal stimulation; pathophysiology; postprandial response