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Etiology and management of low anterior resection syndrome based on the normal defecation mechanism
- Source :
- Surgery Today. 49:803-808
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- Low anterior resection syndrome (LARS) commonly develops after an anal sphincter-preserving operation (SPO). The etiology of LARS is not well understood, as the anatomical components and physiological function of normal defecation, which may be damaged during the SPO, are not well established. SPOs may damage components of the anal canal (such as the internal anal sphincter, longitudinal conjoint muscle, or hiatal ligament), either mechanically or via injury to the nerves that supply these organs. The function of the rectum is substantially impaired by resection of the rectum, division of the rectococcygeus muscle, and/or injury of the nervous supply. When the remnant rectum is small and does not function properly, an important functional role may be played by the neorectum, which is usually constructed from the left side of the colon. Hypermotility of the remnant colon may affect the manifestation of urge fecal incontinence. To develop an SPO that minimizes the risk of LARS, the anatomy and physiology of the structures involved in normal defecation need to be understood better. LARS is managed similarly to fecal incontinence. In particular, management should focus on reducing colonic motility when urge fecal incontinence is the dominant symptom.
- Subjects :
- medicine.medical_specialty
Colon
Anal Canal
Rectum
Internal anal sphincter
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Peripheral Nerve Injuries
Humans
Medicine
Fecal incontinence
Defecation
Digestive System Surgical Procedures
Low Anterior Resection
business.industry
Syndrome
General Medicine
Normal defecation
Plastic Surgery Procedures
Anal canal
Surgery
medicine.anatomical_structure
030220 oncology & carcinogenesis
Ligament
Etiology
030211 gastroenterology & hepatology
medicine.symptom
Gastrointestinal Motility
business
Organ Sparing Treatments
Fecal Incontinence
Subjects
Details
- ISSN :
- 14362813 and 09411291
- Volume :
- 49
- Database :
- OpenAIRE
- Journal :
- Surgery Today
- Accession number :
- edsair.doi.dedup.....b0ca2fa755ed73514a3d113609455fde