Low anterior resection syndrome (LARS): Cause and effect and reconstructive considerations

Techniques in Coloproctology

Volumn 17, Issue 2, 2013, Pages 151-162

  Ziv, Y ^a   Zbar, A ^b   Bar Shavit, Y ^c   Igov, I ^d  

^a ASSAF HAROFEH MEDICAL CENTER   (Israel)

^b SHEBA MEDICAL CENTER   (Israel)

^c HEBREW UNIVERSITY OF JERUSALEM   (Israel)

^d KAPLAN MEDICAL CENTER   (Israel)

Author keywords

Anterior resection syndrome; Fecal incontinence; Soiling

Indexed keywords

ANASTOMOSIS LEAKAGE; ANOPLASTY; ANORECTAL PRESSURE; ANUS SPHINCTER; CANCER RADIOTHERAPY; COLOSTOMY BAG; DEFECATION URGENCY; END TO END ANASTOMOSIS; END TO SIDE ANASTOMOSIS; FECES INCONTINENCE; HUMAN; INCIDENCE; INTESTINAL DYSMOTILITY; LOW ANTERIOR RESECTION SYNDROME; NEUROPATHY; POSTOPERATIVE COMPLICATION; PROCTOCOLECTOMY; QUALITY OF LIFE; RECTUM RESECTION; RESERVOIR; REVIEW; SURGICAL APPROACH; SURGICAL TECHNIQUE; SYMPTOMATOLOGY; ABDOMINAL SURGERY; COLON TUMOR; CONVALESCENCE; FLATULENCE; PATHOPHYSIOLOGY; PLASTIC SURGERY; RECTUM TUMOR; SYNDROME;

COLONIC NEOPLASMS; COLONIC POUCHES; DIGESTIVE SYSTEM SURGICAL PROCEDURES; FECAL INCONTINENCE; FLATULENCE; HUMANS; POSTOPERATIVE COMPLICATIONS; RECONSTRUCTIVE SURGICAL PROCEDURES; RECOVERY OF FUNCTION; RECTAL NEOPLASMS; SYNDROME;

EID: 84884175237     PISSN: 11236337     EISSN: 1128045X     Source Type: Journal    
DOI: 10.1007/s10151-012-0909-3     Document Type: Review

References (129)

1. American Cancer Society. Facts Figures 2007, p 10. http://www.cancer.org/ downloads/STT/ CAFF2007PWSecured.pdf
2. Dixon CF (1948) Anterior resection for malignant lesions of the upper part of the rectum and lower part of the sigmoid. Ann Surg 128:425-442. Reprinted as classic articles in colonic and rectal surgery.
3. Claude F. Dixon 1893-1968. Anterior resection for malignant lesions of the upper part of the rectum and lower part of the sigmoid. Dis Colon Rectum. 1984; 27:419-429
4. Kirwan WO, O'Riordain M, Waldron R (1989) Declining indications for abdominoperineal resection. Br J Surg 76:1061-1063
5. Ravitch MM (1984) Varieties of stapled anastomoses in rectal resection. Surg Clin N Am 64:543-554
6. Heald RJ, Smedh RK, Kald A, Sexton R, Moran BJ (1997) Abdominoperineal excision of the rectum-an endangered operation. Norman Nigro lectureship. Dis Colon Rectum 40:747-751
7. Schneider PM, Vallbohmer D, Ploenes Y et al (2011) Evaluation of quality indicators following implementation of total mesorectal excision in primarily resected rectal cancer changed future management. Int J Colorectal Dis 26:903-909
8. Salerno G, Daniels IR, Moran BJ, Wotherspoon A, Brown G (2006) Clarifying margins in the multidisciplinary management of rectal cancer: the MERCURY experience. Clin Radiol 61:916-923
9. Mohiuddin M, Winter K, Mitchell E, Radiation Therapy Oncology Group Trial 0012 (2006) Randomized phase II study of neoadjuvant combined-modality chemoradiation for distal rectal cancer. J Clin Oncol 24:650-655
10. Glynne-Jones R, Sebag-Montefiore D (2006) Role of neoadjuvant chemotherapy in rectal cancer: interpretation of the EXPERT study. J Clin Oncol 24:4664-4666
11. Paquette IM, Kemp JA, Finlayson SR (2010) Patient and hospital factors associated with use of sphincter-sparing surgery for rectal cancer. Dis Colon Rectum 53:115-120
12. Glynne-Jones R, Wallace M, Livingstone J et al (2008) Complete clinical response after preoperative chemoradiation in rectal cancer: is a wait and see policy justified? Dis Colon Rectum 51:10-20
13. Hingorani M, Hartley JE, Greenman J, Macfie J (2011) Avoiding radical surgery after pre-operative chemoradiotherapy: a possible therapeutic option in rectal cancer? Acta Oncol 51:275-284
14. Thomas C, Madden F, Jehu D (1987) Psychosocial effects of stomas. Psychological morbidity one year after surgery. J Psychosom Res 31:311-316
15. Pachler J, Wille-Jorgensen P (2005) Quality of life after rectal resection for cancer, with or without permanent stoma. Cochrane Database Syst Rev 2:CD004323
16. Ross L, Annemette G, Abild-Nielsen O et al (2007) Quality of life of Danish colorectal cancer patients with and without a stoma. Support Care Cancer 15:505-513
17. Seow-Choen F (1996) Colonic pouches in the treatment of low rectal cancer. Br J Surg 83:881-882
18. Matsuoka H, Masaki T, Sugiyama M, Atomi Y (2005) Impact of lateral pelvic lymph node dissection on evacuatory and urinary functions following low anterior resection for advanced rectal carcinoma. Langenbecks Arch Surg 390:517-522
19. Rutten HJT, den Dulk M, van de Velde CJH, Lemmens VEPP, Marijnen CAM (2008) Controversies of total mesorectal excision for rectal cancer in elderly patioents. Lancet 9:494-501
20. Harris DA, Davies M, Lucas MG, Drew P, Carr ND, Beynon J, Swansea Pelvic Oncology Group (2011) Multivisceral resection for primary locally advanced rectal carcinoma. Br J Surg 98:582-588
21. Devesa JM, Lopez-Hervas P, Vicente R, Rey A, Die J, Fraile A (2005) Total anorectal reconstruction: a novel technique. Tech Coloproctol 9:149-152
22. Wexner SD, Rotholtz NA (2000) Surgeon influenced variables in resectional rectal cancer surgery. Dis Colon Rectum 43:1606-1627
23. Lewis WG, Martin IG, Williamson ME et al (1995) Why do some patients experience poor functional results after anterior resection of the rectum for carcinoma? Dis Colon Rectum 38:259-263
24. O'Riordain MG, Molloy RG, Gillen P, Horgan A, Kirwan WO (1992) Rectoanal inhibitory reflex following low stapled anterior resection of the rectum. Dis Colon Rectum 35:874-878
25. Ortiz H, Armendariz P (1996) Anterior resection: do the patients perceive any clinical benefit? Int J Colorect Dis 11:191-195
26. Montesani C, Pronio A, Santella S et al (2004) Rectal cancer surgery with sphincter preservation: functional results related to the level of anastomosis. Clinical and instrumental study. Hepatogastroenterology 51:718-721
27. Szynglarewicz B, Zietek M, Forgacz J et al (2011) Urinary complications in rectal cancer patients are related to the dissection tool. Hepatogastroenterology 59:115-116
28. Ho VP, Lee Y, Stein SL, Temple LK (2011) Sexual function after treatment for rectal cancer: a review. Dis Colon Rectum 54:113-125
29. Rao G, Drew P, Lee PW, Monson JR, Duthie GS (1996) Anterior resection syndrome is secondary to sympathetic denervation. Int J Colorectal Dis 11:250-258
30. Hallbook O, Sjodahl R (2000) Surgical approaches to obtaining optimal bowel function. Sem Surg Oncol 18:249-258
31. Efthimiadis C, Basdanis G, Zatagias A et al (2004) Manometric and clinical evaluation of patients after low anterior resection for rectal cancer. Tech Coloproctol 8:S205-S207
32. Kakodkar R, Gupta S, Nundy S (2006) Low anterior resection with total mesorectal excision for rectal cancer: functional assessment and factors affecting outcome. Colorectal Dis 8:650-656
33. Farouk R, Duthie G, Lee PWR et al (1998) Endosonographic evidence of injury to the internal anal sphincter after low anterior resection: long-term follow-up. Dis Colon Rectum 41:888-891
34. Ho Y, Tsang C, Tang C et al (2000) Anal sphincter injuries from stapling instruments introduced transanally: randomized, controlled study with endoanal ultrasound and anorectal manometry. Dis Colon Rectum 43:169-173
35. Lee WY, Takahashi T, Pappas T, Mantyh CR, Ludwig KA (2008) Surgical autonomic denervation results in altered colonic motility: an explanation for low anterior resection syndrome? Surgery 143:778-783
36. Matzel K, Stadelmaier U, Muehldorfer S et al (1997) Continence after colorectal reconstruction following resection: impact of level of anastomosis. Int J Colorect Dis 12:82-87
37. Ekkehard C, Jehle E, Haehnel T et al (1995) Level of the anastomosis does not influence functional outcome after anterior rectal resection for rectal cancer. Am J Surg 169:147-153
38. Lewis WG, Holdsworth PJ, Stephenson BM, Finan PJ, Johnston D (1992) Role of the rectum in the physiological and clinical results of coloanal and colorectal anastomosis after anterior resection for rectal carcinoma. Br J Surg 79:1082-1086
39. Hallbook O, Nystrom P, Sjödahl R (1997) Physiologic characteristics of straight and colonic J-pouch anastomoses after rectal excision for cancer. Dis Colon Rectum 40:332-338
40. Batignani G, Monaci I, Ficari F et al (1991) What affects continence after anterior resection of the rectum? Dis Colon Rectum 34:329-335
41. Miller AS, Lewis WG, Williamson ME, Holdsworth PJ, Johnston D, Finan PJ (1995) Factors that influence functional outcome after coloanal anastomosis for carcinoma of the rectum. Br J Surg 82:1327-1330
42. Williamson ME, Lewis WG, Finan PJ, Miller AS, Holdsworth PJ, Johnston D (1995) Recovery of physiologic and clinical function after low anterior resection of the rectum for carcinoma: myth or reality? Dis Colon Rectum 38:411-418
43. Brown SR, Seow-Choen F (2000) Preservation of rectal function after low anterior resection with formation of a neorectum. Sem Surg Oncol 19:376-385
44. Molloy RG, Ooran KT, Coulter J et al (1992) Mechanism of sphincter impairment following low anterior resection. Dis Colon Rectum 35:462-464
45. Otto IC, Ito K, Ye C et al (1996) Causes of rectal incontinence after sphincter-preserving operations for rectal cancer. Dis Colon Rectum 39:1423-1427
46. Nakahara S, Itoh H, Mibu R et al (1998) Clinical and manometric evaluation of anorectal function following low anterior resection with low anastomotic line using an EEA stapler for rectal cancer. Dis Colon Rectum 31:762-766
47. Hallgren T, Fasth S, Delbro D, Nordgren S, Oresland T, Hultén L (1993) Possible role of the autonomic nervous system in sphincter impairment after restorative proctocolectomy. Br J Surg 80:631-635
48. Emmersten KJ, Laurberg S (2012) Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg 255:922-928
49. Hallböök O, Sjödahl R (1996) Anastomotic leakage and functional outcome after anterior resection of the rectum. Br J Surg 83:60-62
50. Nesbakken A, Nygaard K, Lunde OC (2001) Outcome and late functional results after anastomotic leakage following mesorectal excision for rectal cancer. Br J Surg 88:400-404
51. Bittorf B, Stadelmaier U, Merkel S, Hohenberger W, Matzel KE (2003) Does anastomotic leakage affect functional outcome after rectal resection for cancer? Langenbecks Arch Surg 387:406-410
52. Kim N (2005) Anatomic basis of sharp pelvic dissection for curative resection of rectal cancer. Yonsei Med J 46:737-749
53. Heald B (2008) Autonomic nerve preservation in rectal cancer surgery-the forgotten part of the TME message a practical ''workshop'' description for surgeons. Acta Chir Iugosl 55:11-16
54. Sagar PM, Holdsworth PJ, Johnston D (1991) Correlation between laboratory findings and clinical outcome after restorative proctocolectomy: serial studies in 20 patients with end-toend pouch-anal anastomosis. Br J Surg 78:67-70
55. Lin CL, Chen CC (1996) The rectoanal relaxation reflex and continence: in repaired anorectal malformations with and without an internal sphincter saving procedure. J Pediatr Surg 31:630-633
56. Tomita R, Igarashi S (2008) A pathophysiological study using anorectal manometry on patients with or without soiling 5 years or more after low anterior resection for lower rectal cancer. Hepatogastroenterology 55:1584-1588
57. Kang SB, Kim N, Lee KH, Kim YH, Kim JH, Kim JS (2008) Anal sphincter asymmetry in anal incontinence after restorative proctectomy for rectal cancer. World J Surg 32:2083-2088
58. Zbar A, Aslam M, Gold DM, Gatzen C, Gosling A, Kmiot WA (1998) Parameters of the rectoanal inhibitory reflex in patients with idiopathic fecal incontinence and chronic constipation. Dis Colon Rectum 41:200-208
59. Kaur G, Gardiner A, Duthie GS (2002) Rectoanal reflex parameters in incontinence and constipation. Dis Colon Rectum 45:928-933
60. Miller R, Bartolo DC, Cervero F, Mortensen NJ (1988) Anorectal sampling: a comparison of normal and incontinent patients. Br J Surg 75:44-47
61. Miller R, Bartolo DCC, Cervero F, Mortensen NJM (1987) Does preservation of the anal transition zone improve sensation after ileal-anal anastomosis for ulcerative colitis. Clinical controversies in inflammatory bowel disease. Topographia Negri SRC, Bologna, p 205
62. Reilly WT, Pemberton JH, Wolff BG et al (1997) Randomized prospective trial comparing ileal pouch-anal anastomosis performed by excising the anal mucosa to ileal pouch-anal anastomosis performed by preserving the anal mucosa. Ann Surg 225:666-677
63. Fichera A, Ragauskaite L, Silvestri MT et al (2007) Preservation of the anal transition zone in ulcerative colitis. Long-term effects on defecatory function. J Gastrointest Surg 11:1647-1653
64. Holder-Murray J, Fichera A (2009) Anal transition zone in the surgical management of ulcerative colitis. World J Gastroenterol 15:769-773
65. Lovegrove RE, Constantinides VA, Heriot AG et al (2006) A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients. Ann Surg 244:18-26
66. Miller R, Orrom WJ, Duthie G, Bartolo DCC, Mortensen NJM (1990) Ambulatory anorectal physiology in patients following restorative proctocolectomy for ulcerative colitis: comparison with normal controls. Br J Surg 77:895-897
67. Madoff RD, Orrom WJ, Rothenberger DA, Goldberg SM (1990) Rectal compliance: a critical reappraisal. Int J Colorect Dis 5:37-40
68. Zbar AP (2007) Compliance and capacity of the normal human rectum-physical considerations and measurement pitfalls. Acta Chir Iugosl 54:49-57
69. Sorensen M, Rasmussen OO, Tetzschner T, Christiansen J (1992) Physiological variation in rectal compliance. Br J Surg 79:1106-1108
70. Williamson ME, Lewis WG, Holdsworth PJ, Finan PJ, Johnston D (1994) Decrease in the anorectal pressure gradient after low anterior resection of the rectum. A study using continuous ambulatory manometry. Dis Colon Rectum 37:1228-1231
71. Hida J, Yasutomi M, Fujimoto K et al (1996) Functional outcome after low anterior resection with low anastomosis for rectal cancer using the colonic J-pouch: prospective randomized study for determination of optimum pouch size. Dis Colon Rectum 39:986-991
72. Lazorthes F, Gamagami R, Chiotasso P, Istvan G, Muhammad S (1997) Prospective, randomized study comparing clinical results between small and large colonic J-pouch following coloanal anastomosis. Dis Colon Rectum 40:1409-1413
73. Ho YH, Yu S, Ang ES, Seow-Choen F, Sundram F (2002) Small colonic J-pouch improves colonic retention of liquids-randomized, controlled trial with scintigraphy. Dis Colon Rectum 45:76-82
74. Brown CJ, Fenech DS, McLeod RS (2008) Reconstructive techniques after rectal resection for rectal cancer. Cochrane Database Syst Rev 16(2):CD006040
75. Heriot AG, Tekkis PP, Constantinides V et al (2006) Metaanalysis of colonic reservoirs versus straight coloanal anastomosis after anterior resection. Br J Surg 93:19-32
76. Koh PK, Tang CL, Eu KW, Samuel M, Chan E (2007) A systematic review of the function and complications of colonic pouches. Int J Colorectal Dis 22:543-548
77. Halböök O, Pahlman L, Krog M, Wexner SD, Sjöhdahl R (1996) Randomized comparison of straight and colonic J pouch anastomosis after low anterior resection. Ann Surg 224:58-65
78. Ho YH, Tan M, Seow-Choen F (1996) Prospective randomized controlled study of clinical function and anorectal physiology after low anterior resection: comparison of straight and colonic J pouch anastomoses. Br J Surg 83:978-980
79. Lazorthes F, Chiotasso P, Gamagami RA, Istvan G, Chevreau P (1997) Late clinical outcome in a randomized prospective comparison of colonic J pouch and straight coloanal anastomosis. Br J Surg 84:1449-1451
80. Joo JS, Latulippe JF, Alabaz O, Weiss EG, Nogueras JJ, Wexner SD (1998) Long-term functional evaluation of straight coloanal anastomosis and colonic J-pouch: is the functional superiority of colonic J-pouch sustained? Dis Colon Rectum 41:740-746
81. Dehni N, Tiret E, Singland JD et al (1998) Long-term functional outcome after low anterior resection: comparison of low colorectal anastomosis and colonic J-pouch-anal anastomosis. Dis Colon Rectum 41:817-822
82. Barrier A, Martel P, Gallot D, Dugue L, Sezeur A, Malfosse M (1999) Long-term functional results of colonic J pouch versus straight coloanal anastomosis. Br J Surg 86:1176-1179
83. Heah SM, Seow-Choen F, Eu KW, Ho YH, Tang CL (2002) Prospective, randomized trial comparing sigmoid versus descending colonic J-pouch after total rectal excision. Dis Colon Rectum 45:322-328
84. Machado M, Nygren J, Goldman S, Ljungqvist O (2005) Functional and physiologic assessment of the colonic reservoir or side-to-end anastomosis after low anterior resection for rectal cancer: a two-year follow-up. Dis Colon Rectum 48:29-36
85. Fürst A, Burghofer K, Hutzel L, Jauch KW (2002) Neorectal reservoir is not the functional principle of the colonic J-pouch: the volume of the short colonic J-pouch does not differ from a straight coloanal anastomosis. Dis Colon Rectum 45:660-667
86. Park JG, Lee MR, Lim SB et al (2005) Colonic J-pouch anal anastomosis after ultralow anterior resection with upper sphincter excision for low-lying rectal cancer. World J Gastroenterol 11:2570-2573
87. Z'graggen K, Maurer CA, Birrer S, Giachino D, Kern B, Buchler MW (2001) A new surgical concept for rectal replacement after low anterior resection: the transverse coloplasty pouch. Ann Surg 234:780-785
88. Ho YH, Brown S, Heah SM et al (2005) Comparison of J-pouch and coloplasty pouch for low rectal cancers: a randomized, controlled trial investigating functional results and comparative anastomotic leak rates. Ann Surg 236:49-55
89. Fürst A, Suttner S, Agha A, Beham A, Jauch KW (2003) Colonic J-pouch versus coloplasty following resection of distal rectal cancer: early results of a prospective, randomized, pilot study. Dis Colon Rectum 46:1161-1166
90. Baker JW (1950) Low end to side rectosigmoidal anastomosis: description of the technique. Arch Surg 61:143-157
91. Jiang J-K, Yang S-H, Lin J-K (2005) Transabdominal anastomosis after low anterior resection: a prospective, randomized, controlled trial comparing long-term results between side-to-end anastomosis and colonic J-pouch. Dis Colon Rectum 48:2100-2110
92. Harris GK, Lavery IC, Fazio VW et al (2001) Function of a colonic J pouch continues to improve with time. Br J Surg 88:1623-1627
93. Machado M, Nygren J, Goldman S et al (2003) Similar outcome after colonic pouch and side-to-end anastomosis in low anterior resection for rectal cancer: a prospective randomized trial. Ann Surg 238:214-220
94. Huber FT, Herter B, Siewert JR (1999) Colonic pouch versus side-to-end anastomosis in low anterior resection. Dis Colon Rectum 42:896-902
95. Tsunoda A, Kamiyama G, Narita K, Watanabe M, Nakao K, Kusano M (2009) Prospective randomized trial for determination of optimum size of side limb in low anterior resection with side-to-end anastomosis for rectal carcinoma. Dis Colon Rectum 52:1572-1577
96. Fazio VW, Zutshio M, Remzi FH et al (2007) A randomized multicenter trial to compare long-term functional outcome, quality of life and complications of surgical procedures for low rectal cancers. Ann Surg 246:481-488
97. Mantyh CR, Hull TL, Fazio VW (2001) Coloplasty in low colorectal anastomosis: manometric and functional comparison with straight and colonic J-pouch anastomosis. Dis Colon Rectum 44:37-42
98. Pimentel JM, Duarte A, Gregorio C, Souto P, Patricio J (2003) Transverse coloplasty pouch and colonic J-pouch for rectal cancer-a comparative study. Colorectal Dis 5:465-470
99. Yang Y-H, Nie L, Yu F-B et al (2006) A comparison of defecation function between coloplasty pouch and colonic J-pouch in patients after resection for rectal carcinoma. Clin J Cen Surg 21:816-818
100. Ulrich AB, Seiler CM, Z'graggen K, Löffler T, Weitz J, Büchler MW (2008) Early results fro a randomized clinical trial of colon J pouch versus transverse coloplasty pouch after low anterior resection for rectal cancer. Br J Surg 95:1257-1263
101. Köninger JS, Butters M, Redecke JD, Z'graggen K (2004) Transverse coloplasty pouch after total mesorectal excision: functional assessment of evacuation. Dis Colon Rectum 47:1586-1593
102. Liao C, Gao F, Cao Y, Tan A, Li X, Wu D (2010) Meta-analysis of the colon J-pouch versus transverse coloplasty poouch after anterior resection for rectal cancer. Colorectal Dis 12:624-631
103. Remzi FH, Fazio VW, Gorgun E et al (2005) Quality of life, functional outcome and complications of coloplasty pouch after low anterior resection. Dis Colon Rectum 48:735-743
104. Nathanson DR, Espat NJ, Nash GM et al (2003) Evaluation of preoperative and postoperative radiotherapy on long-term functional results of straight coloanal anastomosis. Dis Colon Rectum 46:888-894
105. Kollmorgen CF, Meagher AP, Wolff BG, Pemberton JH, Martenson JA, Illstrup DM (1994) The long-term effect of adjuvant postoperative chemoradiotherapy for rectal carcinoma on bowel function. Ann Surg 220:676-682
106. Dalhlberg M, Glimelius B, Graf W, Pahlman L (1998) Preoperative irradiation affects functional results after surgery for rectal cancer: results from a randomized study. Dis Colon Rectum 41:543-551
107. Birnbaum EH, Myerson RJ, Fry RD, Kodner IJ, Fleshman JW (1994) Chronic effects of pelvic radiation therapy on anorectal function. Dis Colon Rectum 37:909-915
108. Gervaz P, Rotholtz N, Pisano M et al (2001) Quantitative short term study of anal sphincter function after chemoradiation for rectal cancer. Arch Surg 41:543-551
109. Van Duijvendijk P, Slors JF, Taat CW et al (2002) Prospective evaluation of anorectal function after total mesorectal excision for rectal carcinoma with or without preoperative radiotherapy. Am J Gastroenterol 97:2282-2289
110. Rullier E, Goffre B, Bonnel C, Zerbib F, Caudry M, Saric J (2001) Preoperative radiochemotherapy and sphincter-saving resection for T3 carcinomas of the lower third of the rectum. Ann Surg 234:633-640
111. Ammann K, Kirchmayr W, Klaus A et al (2003) Impact of neoadjuvant chemoradiation on anal sphincter function in patients with carcinoma of the midrectum and low rectum. Arch Surg 138:257-261
112. Parc Y, Zutshi M, Zalinski S, Ruppert R, Furst A, Fazio VW (2009) Preoperative radiotherapy is associated with worse functional results after coloanal anastomosis for rectal cancer. Dis Colon Rectum 52:2004-2015
113. Varma JS, Smith AN, Busuttil A (1986) Function of the anal sphincters after chronic radiation injury. Gut 27:528-536
114. Mameghan H, Fischer R, Mameghan J, Watt WH, Tynan A (1990) Bowel complications after radiotherapy for carcinoma of the prostate: the volume effect. Int J Radiat Oncol Biol Phys 18:315-320
115. Perez CA, Lee HK, Georgiou A, Lockett MA (1994) Technical factors affecting morbidity in definitive irradiation for localized carcinoma of the prostate. Int J Radiat Oncol Biol Phys 28:811-819
116. DaSilva GM, Berho M, Efron J et al (2001) Histological analysis of the anal sphincter after radiotherapy. Colorectal Dis 3:56-57
117. Lim JF, Tjandra JJ, Hiscock R, Chao MWT, Gibbs P (2005) Preoperative chemoradiation for rectal cancer causes prolonged pudendal nerve terminal motor latency. Dis Colon Rectum 49:12-19
118. Frykholm GJ, Sintorn K, Montelius A et al (1996) Acute lumbosacral plexopathy during and after preoperative radiotherapy of rectal adenocarcinoma. Radiother Oncol 38:121-130
119. Yeoh E, Botten RB, Russo A et al (2000) Chronic effects of therapeutic irradiation for localized prostatic carcinoma on anorectal function. Int Radiat Oncol Biol Phys 47:915-922
120. Krol R, Hopman WP, Smeenk RJ, Van Lin EN (2012) Increased rectal wall stiffness after prostate radiotherapy: relation with fecal urgency. Neurogastroenterol Motil. Jan 11. doi: 10.1111/j.1365-2982.2011.01858.x. (Epub ahead of print)
121. Ooi BS, Tjandra JJ, Green MD (1999) Morbidities of adjuvant chemotherapy and radiotherapy for respectable rectal cancer: an overview. Dis Colon Rectum 42:403-418
122. Lorchel F, Peignaux K, Créhange G et al (2007) Preoperative radiotherapy in elderly patients with rectal cancer. Gastroenterol Clin Biol 31:436-441
123. Hallböök O, Johansson K, Sjödahl R (1996) Laser Doppler blood flow measurement in rectal resection for carcinoma-comparison between straight and colonic pouch. Br J Surg 83:389-392
124. Zbar AP, Kennedy PJ, Singh V (2009) Functional outcome following restorative rectal cancer surgery. Acta Chir Iugosl 56:9-16
125. de Gouveia Santos VL, Chaves EC, Kimura M (2006) Quality of life and coping of persons with temporary and permanent stomas. J Wound Ostomy Continence Nurs 33:503-509
126. Pigazzi A, Luca F, Patriti A et al (2010) Multicentric study on robotic tumor-specific mesorectal excision for the treatment of rectal cancer. Ann Surg Oncol 17:1614-1620
127. deSouza AL, Prasad LM, Marecik SJ et al (2010) Total mesorectal excision for rectal cancer: the potential advantage of robotic assistance. Dis Colon Rectum 53:1611-1617
128. Holzer B, Rosen HR, Zaglmaier W et al (2008) Sacral nerve stimulation in patients after rectal resection-preliminary report. J Gastrointest Surg 12:921-925
129. Moya P, Arroyo A, Soriano-Irigaray L, Frangi A, Candela Polo F, Calpena Rico R (2012) Sacral nerve stimulation in patients with severe fecal incontinence after rectal resection. Tech Coloproctol 16:263-264