@article{JGO25831,
author = {Sumito Sato and Manabu Shiozawa and Mamoru Uchiyama and Nobuhiro Sugano and Yasushi Rino and Munetaka Masuda},
title = {Correlation between endoscopic features of the anastomosis after low anterior resection and postsurgical anorectal function},
journal = {Journal of Gastrointestinal Oncology},
volume = {10},
number = {2},
year = {2018},
keywords = {},
abstract = {Background: With low anterior resection (LAR) for rectal cancer, the oncologic outcomes are recently good. A diverting ileostomy is often created to protect the newly constructed anastomosis; seldom is a permanent stoma needed. Predicting postoperative anorectal function remains difficult, however. We speculated that the endoscopic appearance of the anastomosis before ileostomy closure is predictive of the post-operative anorectal function and tested our hypothesis retrospectively.
Methods: Included in the study were 80 patients who, between September 2014 and August 2017, underwent LAR at Kanagawa Cancer Center. A diverting stoma had been created during the primary surgery, and ileostomy closure was performed about 6 months later. The anastomosis was examined endoscopically just before ileostomy closure, and the features were scored by two well-trained endoscopists. Daily defecation frequency and incontinence (Kirwan Score) were assessed after closure through physician-patient interview, and correlation between endoscopic feature scores and these measures of anorectal function was tested.
Results: Documented endoscopic features included erythema in 79% of patients, erosion (45%), ulceration (5%), granulomatous change (41.3%), granular protrusions (17.5%); hemorrhagic (20.0%) or white-coated (30.0%) mucosa. Anastomosis stricture },
issn = {2219-679X}, url = {https://jgo.amegroups.org/article/view/25831}
}