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Rasulov A.O.

Lopatkin Research Institute of Urology and Interventional Radiology;
Evdokimov Moscow State University of Medicine and Dentistry

Baychorov A.B.

Loginov Moscow Clinical Scientific Center

Merzlykova A.M.

Blokhin Russian Cancer Research Center

Ovchinnikova A.I.

Blokhin Russian Cancer Research Center

Semyanikhina A.V.

Blokhin Russian Cancer Research Center

Surgical treatment of low anterior resection syndrome

Authors:

Rasulov A.O., Baychorov A.B., Merzlykova A.M., Ovchinnikova A.I., Semyanikhina A.V.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2020;(11): 53‑60

DOI: 10.17116/hirurgia202011153

Views: 5344

Downloaded: 128

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To cite this article:

Rasulov AO, Baychorov AB, Merzlykova AM, Ovchinnikova AI, Semyanikhina AV. Surgical treatment of low anterior resection syndrome. Pirogov Russian Journal of Surgery. 2020;(11):53‑60. (In Russ.)
https://doi.org/10.17116/hirurgia202011153

Подписка 2025 (Pirogov Russian Journal of Surgery)
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OBJECTIVE

To compare functional outcomes of various rectal reconstruction after total mesorectal excision.

MATERIAL AND METHODS

A prospective randomized trial included 90 patients with mid-to-low rectal carcinoma who underwent total mesorectal excision.

RESULTS

There were 22 patients after J-pouch surgery, 30 patients with side-to-end anastomoses and 38 patients with end-to-end anastomoses. Eight patients (26.6%) required conversion of J-P to E-E (7 patients) and S-E (1) anastomosis for technical reasons. Postoperative morbidity was similar (13.6, 16.7 and 34.2% in J-P, S-E and E-E groups, respectively, p=0.705). Sensory threshold, earliest and constant defecation urge and maximal tolerable volume were higher for J-P surgery within 3-6-12 months after surgery. Stool frequency was significantly lower after J-P surgery compared to S-E and E-E anastomoses within 3—6—12 months. Wexner scores were 3, 5, 6 after 6 months (p<0.05) and 0, 1, 1 after 12 months for J-P, S-E and E-E, respectively (p>0.05). Evacuation dysfunction was observed in 59.1% with J-P, 33.3% with S-E and 21.1% with E-E anastomoses in 6 months after stoma closure.

CONCLUSION

J-pouch reconstruction demonstrates higher neorectal volume that ensures reduced stool frequency up to 12 months after stoma closure. However, technical challenges of J-pouch surgery and evacuation dysfunction restrain application of this procedure in clinical practice.

Keywords:

rectal cancer
low anterior resection
J-pouch
total mesorectal excision

Authors:

Rasulov A.O.

Lopatkin Research Institute of Urology and Interventional Radiology;
Evdokimov Moscow State University of Medicine and Dentistry

Baychorov A.B.

Loginov Moscow Clinical Scientific Center

Merzlykova A.M.

Blokhin Russian Cancer Research Center

Ovchinnikova A.I.

Blokhin Russian Cancer Research Center

Semyanikhina A.V.

Blokhin Russian Cancer Research Center

Received:

07.11.2019

Accepted:

10.12.2019

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