Altered colonic motility is associated with low anterior resection syndrome.
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
20
09
2020
revised:
13
10
2020
accepted:
17
11
2020
pubmed:
1
12
2020
medline:
19
8
2021
entrez:
30
11
2020
Statut:
ppublish
Résumé
Patients frequently suffer from low anterior resection syndrome (LARS) after distal colorectal resection. The pathophysiology of LARS has not been clearly elucidated. We hypothesized that rectosigmoid resection could impair motility patterns in the distal colon, such as the rectosigmoid brake, which contribute to control of stool form and frequency. High-resolution colonic manometry was performed in patients who had previously undergone distal colorectal resection (mean 6.8 years after resection) and non-operative controls before and after a standardized meal. Symptoms were assessed using the LARS score. Propagating contractions were compared between patients with and without LARS, and controls. Data were analysed from 23 patients (11 no-LARS; 12 LARS) and nine controls. All groups demonstrated a significant meal response. LARS patients had fewer post-prandial antegrade propagating contractions than controls (P = 0.028), and fewer retrograde propagating contractions both pre- (P = 0.005) and post-prandially (P = 0.004). Post-prandially, the LARS group had a significantly lower percentage of propagating contractions that met the criteria for the cyclic motor pattern compared to the control group (26% vs. 58%; P = 0.009). There were significant differences in antegrade and retrograde amplitude (P = 0.049; P = 0.018) and distance of propagation (P = 0.003; P = 0.002) post-prandially between LARS patients and controls. Rectosigmoid resection alters the meal response following anterior resection, including impairment of the rectosigmoid brake cyclic motor pattern. These findings help to quantify the impaired functional motility after rectosigmoid resection and offer new insights into the mechanisms of LARS.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
415-423Subventions
Organisme : Auckland Medical Research Foundation
ID : 1415003
Organisme : Royal Australasian College of Surgeons
Organisme : New Zealand Health Research Council
Organisme : Medical Technologies Centre of Research Excellence
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2020 The Association of Coloproctology of Great Britain and Ireland.
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