Current status and research progress in the assessment of anal function after transanal total mesorectal resection_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

FAN Yushi , YANG Bangcui ,  REN Mingyang

Department of Gastrointestinal Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;

Corresponding author：

REN Mingyang, Email: 2861746489@qq.com

Keywords：

rectal cancer; transanal total mesorectal resection; anal function; anorectal manometry; review

DOI：

10.7507/1007-9424.202008092

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the current commonly used anal function assessment methods after anorectal preservation surgery, and to discuss the current status of research and existing problems of anal function in patients after transanal total mesorectal excision (taTME) surgery.Method By searching the relevant literatures in domestic and international databases, the studies on anal function of patients after taTME and the studies on anal function assessment tools after anorectal preservation surgery were included to make an review.Results There was little literatures on the recovery of anal function after taTME, especially the long-term recovery of anal function after taTME was still unclear. The anal function in the early stage after traditional anal preserving operation for rectal cancer may be superior to taTME, but the recovery of anal function in the middle and long term after operation was similar. In terms of research tools, most of the current studies tend to use scale assessment method to describe the recovery of anal function after taTME, while the objective quantitative index, such as anorectal manometry and anal ultrasound were rarely used.Conclusion At present, there is a single and inconsistent research tool for the study of postoperative anal function after taTME, so further research is still needed to provide data reference for the postoperative anal function recovery curve of rectal cancer patients.

Citation： FAN Yushi, YANG Bangcui, REN Mingyang. Current status and research progress in the assessment of anal function after transanal total mesorectal resection. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(6): 821-825. doi: 10.7507/1007-9424.202008092 Copy

1.	张忠涛, 郑民华, 姚宏伟, 等. 直肠癌经肛全直肠系膜切除专家共识及手术操作指南 (2017 版). 中国实用外科杂志, 2017, 37(9): 978-984.
2.	Emile SH, de Lacy FB, Keller DS, et al. Evolution of transanal total mesorectal excision for rectal cancer: from top to bottom. World J Gastrointest Surg, 2018, 10(3): 28-39.
3.	姚宏伟, 张忠涛, 郑民华. 直肠癌经肛全直肠系膜切除中国专家共识及临床实践指南 (2019 版). 中国实用外科杂志, 2019, 39(11): 1121-1128.
4.	Sylla P, Rattner DW, Delgado S, et al. NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance. Surg Endosc, 2010, 24(5): 1205-1210.
5.	张浩, 张云生, 金雄伟, 等. 完全经肛单孔腹腔镜全直肠系膜切除术治疗直肠癌. 中国内镜杂志, 2012, 18(4): 379-383.
6.	张鹏飞, 张凯. 腹腔镜直肠癌经肛全直肠系膜切除术的临床研究. 中国肿瘤外科杂志, 2019, 11(3): 206-209.
7.	Deijen CL, Velthuis S, Tsai A, et al. COLOR Ⅲ: a multicentre randomised clinical trial comparing transanal TME versus laparoscopic TME for mid and low rectal cancer. Surg Endosc, 2016, 30(8): 3210-3215.
8.	Hasegawa H, Okabayashi K, Tsuruta M, et al. Evolution of surgery for rectal cancer: transanal total mesorectal excision~new standard or fad?~. J Anus Rectum Colon, 2018, 2(4): 115-121.
9.	龙飞, 欧阳军, 陈向恒, 等. 腹腔镜辅助经肛全直肠系膜切除术治疗中低位直肠癌的临床分析 (附 32 例报告). 中国内镜杂志, 2020, 26(2): 11-18.
10.	靳鹏辉, 胡立冬, 李小飞, 等. 经肛门全直肠系膜切除术在中低位直肠癌中的疗效及安全性的系统评价和 Meta 分析. 中国内镜杂志, 2019, 25(6): 25-33.
11.	Maykel JA, Phatak UR, Suwanabol PA, et al. Initiation of a transanal total mesorectal excision program at an academic training program: evaluating patient safety and quality outcomes. Dis Colon Rectum, 2017, 60(12): 1267-1272.
12.	Keane C, Wells C, O’Grady G, et al. Defining low anterior resection syndrome: a systematic review of the literature. Colorectal Dis, 2017, 19(8): 713-722.
13.	Koda K, Yamazaki M, Shuto K, et al. Etiology and management of low anterior resection syndrome based on the normal defecation mechanism. Surg Today, 2019, 49(10): 803-808.
14.	高加勒, 安勇博, 汪栋, 等. 直肠癌保肛术后短期生活质量研究现状. 中华胃肠外科杂志, 2020, 23(4): 415-420.
15.	马全民, 申占龙, 刘凡, 等. 经肛全直肠系膜切除与腹腔镜全直肠系膜切除术后肛门功能的比较. 中华结直肠疾病电子杂志, 2018, 7(4): 337-341.
16.	叶志伟, 陈远光, 胡明, 等. 直肠癌经肛内镜全直肠系膜切除术对肛门功能影响的临床研究. 中国普通外科杂志, 2015, 24(4): 473-477.
17.	Carrington EV, Scott SM, Bharucha A, et al. Expert consensus document: advances in the evaluation of anorectal function. Nat Rev Gastroenterol Hepatol, 2018, 15(5): 309-323.
18.	Carrington EV, Heinrich H, Knowles CH, et al. The international anorectal physiology working group (IAPWG) recommendations: standardized testing protocol and the London classification for disorders of anorectal function. Neurogastroenterol Motil, 2020, 32(1): e13679.
19.	Carrington EV, Heinrich H, Knowles CH, et al. Methods of anorectal manometry vary widely in clinical practice: results from an international survey. Neurogastroenterol Motil, 2017, 29(8): e13016.
20.	侯晓华. 消化道高分辨率测压图谱. 北京: 科学出版社, 2014: 1-3.
21.	皮艳娜, 肖毅, 王智凤, 等. 新辅助放化疗对中低位直肠癌患者肛门直肠功能的影响. 中华医学杂志, 2014, 94(24): 1857-1860.
22.	Kochi M, Egi H, Adachi T, et al. Preoperative incremental maximum squeeze pressure as a predictor of fecal incontinence after very low anterior resection for low rectal cancer. Surg Today, 2020, 50(5): 516-524.
23.	Andrianjafy C, Luciano L, Bazin C, et al. Three-dimensional high-resolution anorectal manometry in functional anorectal disorders: results from a large observational cohort study. Int J Colorectal Dis, 2019, 34(4): 719-729.
24.	Mandaliya R, DiMarino AJ, Moleski S, et al. Survey of anal sphincter dysfunction using anal manometry in patients with fecal incontinence: a possible guide to therapy. Ann Gastroenterol, 2015, 28(4): 469-474.
25.	杨敏, 安果仙, 孙小兵, 等. 肛管内超声对肛门直肠畸形术后肛门功能异常患儿的评估价值. 中华胃肠外科杂志, 2017, 20(11): 1306-1308.
26.	王永刚, 孙源. 术前三维肛管直肠腔内超声检查对肛瘘手术的疗效分析. 中国普外基础与临床杂志, 2021, 28(1): 85-88.
27.	Chamié LP, Ribeiro DMFR, Caiado AHM, et al. Translabial US and dynamic MR imaging of the pelvic floor: normal anatomy and dysfunction. Radiographics, 2018, 38(1): 287-308.
28.	顾程. 动态 MRI 检查结合 3D HR-ARM 技术对低位直肠癌保肛术后排便功能障碍的评价研究. 天津: 天津医科大学, 2017.
29.	赵亚婧. 低位直肠癌保肛术联合预防性回肠造口术后肛门直肠功能的影像评估. 天津: 天津医科大学, 2018.
30.	Emmertsen KJ, Laurberg S. 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, 2012, 255(5): 922-928.
31.	曹兰玉, 魏力, 王春梅. 直肠癌前切除综合征评分量表的汉化及信效度评价. 中国实用护理杂志, 2013, 29(27): 69-72.
32.	闫晶晶, 牟绍玉, 谭人福, 等. 直肠癌低位前切除综合征评分表中文版的实证研究. 解放军护理杂志, 2015, 32(4): 12-15.
33.	Meyer R, Alcalay M, Jamal R, et al. Validation of the Wexner scale in a Hebrew-speaking population. Int Urogynecol J, 2020, 31(12): 2583-2587.
34.	赵晓堂, 戴雷, 卢云, 等. 4 种量表对低位直肠癌保肛患者的肛门功能的评价. 临床医学研究与实践, 2016, 1(1): 1-3, 15.
35.	李卡, 黄明君, 谢娟, 等. 4 种量表评估直肠癌保肛病人术后 1 个月肛门功能的比较. 护理研究, 2013, 27(1): 93-94.
36.	陈思. 肠道术后患者肠蠕动功能恢复影响因素的研究. 长春: 吉林大学, 2016.
37.	魏汝玉. 研究腹腔镜直肠癌经肛门全直肠系膜切除术 (TaTME) 与传统腹腔镜术式的疗效//全国科研理论学术研究成果汇编 (二). 中国环球文化出版社、华教创新 (北京) 文化传媒有限公司: 华教创新(北京)文化传媒有限公司, 2020: 212-215.
38.	李仕兴, 康安. 腹腔镜直肠癌经肛门全直肠系膜切除术与传统腹腔镜术式疗效对比. 现代消化及介入诊疗, 2018, 23(6): 782-785.
39.	徐忠发, 左文述, 刘奇. 现代肛肠肿瘤外科学. 济南: 山东科学技术出版社, 1993: 258-260.
40.	刘思达, 刘栋, 段降龙. 腹腔镜辅助经肛门全直肠系膜切除术与全直肠系膜切除术的临床对比研究. 中华普外科手术学杂志 (电子版), 2020, 14(1): 42-45.
41.	窦若虚, 孙伟鹏, 罗双灵, 等. 经肛全直肠系膜切除与腹腔镜全直肠系膜切除术后患者的肠道功能: 基于随机临床研究的比较. 中华胃肠外科杂志, 2019, 22(3): 246-254.
42.	Koedam TW, van Ramshorst GH, Deijen CL, et al. Transanal total mesorectal excision (TaTME) for rectal cancer: effects on patient-reported quality of life and functional outcome. Tech Coloproctol, 2017, 21(1): 25-33.
43.	van der Heijden JAG, Koëter T, Smits LJH, et al. Functional complaints and quality of life after transanal total mesorectal excision: a meta-analysis. Br J Surg, 2020, 107(5): 489-498.

1. 张忠涛, 郑民华, 姚宏伟, 等. 直肠癌经肛全直肠系膜切除专家共识及手术操作指南 (2017 版). 中国实用外科杂志, 2017, 37(9): 978-984.
2. Emile SH, de Lacy FB, Keller DS, et al. Evolution of transanal total mesorectal excision for rectal cancer: from top to bottom. World J Gastrointest Surg, 2018, 10(3): 28-39.
3. 姚宏伟, 张忠涛, 郑民华. 直肠癌经肛全直肠系膜切除中国专家共识及临床实践指南 (2019 版). 中国实用外科杂志, 2019, 39(11): 1121-1128.
4. Sylla P, Rattner DW, Delgado S, et al. NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance. Surg Endosc, 2010, 24(5): 1205-1210.
5. 张浩, 张云生, 金雄伟, 等. 完全经肛单孔腹腔镜全直肠系膜切除术治疗直肠癌. 中国内镜杂志, 2012, 18(4): 379-383.
6. 张鹏飞, 张凯. 腹腔镜直肠癌经肛全直肠系膜切除术的临床研究. 中国肿瘤外科杂志, 2019, 11(3): 206-209.
7. Deijen CL, Velthuis S, Tsai A, et al. COLOR Ⅲ: a multicentre randomised clinical trial comparing transanal TME versus laparoscopic TME for mid and low rectal cancer. Surg Endosc, 2016, 30(8): 3210-3215.
8. Hasegawa H, Okabayashi K, Tsuruta M, et al. Evolution of surgery for rectal cancer: transanal total mesorectal excision~new standard or fad?~. J Anus Rectum Colon, 2018, 2(4): 115-121.
9. 龙飞, 欧阳军, 陈向恒, 等. 腹腔镜辅助经肛全直肠系膜切除术治疗中低位直肠癌的临床分析 (附 32 例报告). 中国内镜杂志, 2020, 26(2): 11-18.
10. 靳鹏辉, 胡立冬, 李小飞, 等. 经肛门全直肠系膜切除术在中低位直肠癌中的疗效及安全性的系统评价和 Meta 分析. 中国内镜杂志, 2019, 25(6): 25-33.
11. Maykel JA, Phatak UR, Suwanabol PA, et al. Initiation of a transanal total mesorectal excision program at an academic training program: evaluating patient safety and quality outcomes. Dis Colon Rectum, 2017, 60(12): 1267-1272.
12. Keane C, Wells C, O’Grady G, et al. Defining low anterior resection syndrome: a systematic review of the literature. Colorectal Dis, 2017, 19(8): 713-722.
13. Koda K, Yamazaki M, Shuto K, et al. Etiology and management of low anterior resection syndrome based on the normal defecation mechanism. Surg Today, 2019, 49(10): 803-808.
14. 高加勒, 安勇博, 汪栋, 等. 直肠癌保肛术后短期生活质量研究现状. 中华胃肠外科杂志, 2020, 23(4): 415-420.
15. 马全民, 申占龙, 刘凡, 等. 经肛全直肠系膜切除与腹腔镜全直肠系膜切除术后肛门功能的比较. 中华结直肠疾病电子杂志, 2018, 7(4): 337-341.
16. 叶志伟, 陈远光, 胡明, 等. 直肠癌经肛内镜全直肠系膜切除术对肛门功能影响的临床研究. 中国普通外科杂志, 2015, 24(4): 473-477.
17. Carrington EV, Scott SM, Bharucha A, et al. Expert consensus document: advances in the evaluation of anorectal function. Nat Rev Gastroenterol Hepatol, 2018, 15(5): 309-323.
18. Carrington EV, Heinrich H, Knowles CH, et al. The international anorectal physiology working group (IAPWG) recommendations: standardized testing protocol and the London classification for disorders of anorectal function. Neurogastroenterol Motil, 2020, 32(1): e13679.
19. Carrington EV, Heinrich H, Knowles CH, et al. Methods of anorectal manometry vary widely in clinical practice: results from an international survey. Neurogastroenterol Motil, 2017, 29(8): e13016.
20. 侯晓华. 消化道高分辨率测压图谱. 北京: 科学出版社, 2014: 1-3.
21. 皮艳娜, 肖毅, 王智凤, 等. 新辅助放化疗对中低位直肠癌患者肛门直肠功能的影响. 中华医学杂志, 2014, 94(24): 1857-1860.
22. Kochi M, Egi H, Adachi T, et al. Preoperative incremental maximum squeeze pressure as a predictor of fecal incontinence after very low anterior resection for low rectal cancer. Surg Today, 2020, 50(5): 516-524.
23. Andrianjafy C, Luciano L, Bazin C, et al. Three-dimensional high-resolution anorectal manometry in functional anorectal disorders: results from a large observational cohort study. Int J Colorectal Dis, 2019, 34(4): 719-729.
24. Mandaliya R, DiMarino AJ, Moleski S, et al. Survey of anal sphincter dysfunction using anal manometry in patients with fecal incontinence: a possible guide to therapy. Ann Gastroenterol, 2015, 28(4): 469-474.
25. 杨敏, 安果仙, 孙小兵, 等. 肛管内超声对肛门直肠畸形术后肛门功能异常患儿的评估价值. 中华胃肠外科杂志, 2017, 20(11): 1306-1308.
26. 王永刚, 孙源. 术前三维肛管直肠腔内超声检查对肛瘘手术的疗效分析. 中国普外基础与临床杂志, 2021, 28(1): 85-88.
27. Chamié LP, Ribeiro DMFR, Caiado AHM, et al. Translabial US and dynamic MR imaging of the pelvic floor: normal anatomy and dysfunction. Radiographics, 2018, 38(1): 287-308.
28. 顾程. 动态 MRI 检查结合 3D HR-ARM 技术对低位直肠癌保肛术后排便功能障碍的评价研究. 天津: 天津医科大学, 2017.
29. 赵亚婧. 低位直肠癌保肛术联合预防性回肠造口术后肛门直肠功能的影像评估. 天津: 天津医科大学, 2018.
30. Emmertsen KJ, Laurberg S. 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, 2012, 255(5): 922-928.
31. 曹兰玉, 魏力, 王春梅. 直肠癌前切除综合征评分量表的汉化及信效度评价. 中国实用护理杂志, 2013, 29(27): 69-72.
32. 闫晶晶, 牟绍玉, 谭人福, 等. 直肠癌低位前切除综合征评分表中文版的实证研究. 解放军护理杂志, 2015, 32(4): 12-15.
33. Meyer R, Alcalay M, Jamal R, et al. Validation of the Wexner scale in a Hebrew-speaking population. Int Urogynecol J, 2020, 31(12): 2583-2587.
34. 赵晓堂, 戴雷, 卢云, 等. 4 种量表对低位直肠癌保肛患者的肛门功能的评价. 临床医学研究与实践, 2016, 1(1): 1-3, 15.
35. 李卡, 黄明君, 谢娟, 等. 4 种量表评估直肠癌保肛病人术后 1 个月肛门功能的比较. 护理研究, 2013, 27(1): 93-94.
36. 陈思. 肠道术后患者肠蠕动功能恢复影响因素的研究. 长春: 吉林大学, 2016.
37. 魏汝玉. 研究腹腔镜直肠癌经肛门全直肠系膜切除术 (TaTME) 与传统腹腔镜术式的疗效//全国科研理论学术研究成果汇编 (二). 中国环球文化出版社、华教创新 (北京) 文化传媒有限公司: 华教创新(北京)文化传媒有限公司, 2020: 212-215.
38. 李仕兴, 康安. 腹腔镜直肠癌经肛门全直肠系膜切除术与传统腹腔镜术式疗效对比. 现代消化及介入诊疗, 2018, 23(6): 782-785.
39. 徐忠发, 左文述, 刘奇. 现代肛肠肿瘤外科学. 济南: 山东科学技术出版社, 1993: 258-260.
40. 刘思达, 刘栋, 段降龙. 腹腔镜辅助经肛门全直肠系膜切除术与全直肠系膜切除术的临床对比研究. 中华普外科手术学杂志 (电子版), 2020, 14(1): 42-45.
41. 窦若虚, 孙伟鹏, 罗双灵, 等. 经肛全直肠系膜切除与腹腔镜全直肠系膜切除术后患者的肠道功能: 基于随机临床研究的比较. 中华胃肠外科杂志, 2019, 22(3): 246-254.
42. Koedam TW, van Ramshorst GH, Deijen CL, et al. Transanal total mesorectal excision (TaTME) for rectal cancer: effects on patient-reported quality of life and functional outcome. Tech Coloproctol, 2017, 21(1): 25-33.
43. van der Heijden JAG, Koëter T, Smits LJH, et al. Functional complaints and quality of life after transanal total mesorectal excision: a meta-analysis. Br J Surg, 2020, 107(5): 489-498.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Current status and research progress in the assessment of anal function after transanal total mesorectal resection

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