Anorectal function after low anterior resection

Most patients with rectal carcinoma can now be treated with sphincter-sparing procedures. The quality of life after sphincter-sparing procedures is better than after abdominoperineal excision. However, morphology and physiology of the neorectum/ sphincter complex are challenged and enthusians towards restorative surgery in rectal cancer was tempered by concerns over functional deficits: after low anterior resection a substantial portion of patients experience impaired anorectal function, in particular fecal leakage and urgency of defecation and report disturbed sexual function. The aim of our work was to investigate functional outcome and anorectal physiologic function as measured by manometry after the three most commonly used reconstructions of intestinal continuity: anterior rectal resection, low anterior rectal, and intersphincteric rectal resection.