ObjectiveTo 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.MethodBy 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.ResultsThere 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.ConclusionAt 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.
ObjectiveTo evaluate the postoperative anal function of rectal cancer patients treated with transanal total mesorectal excision (taTME), and to analyze the influencing factors which resulted in low anterior resection syndrome (LARS) after taTME in this paper, so as to provide guidance for clinical practice.MethodsThe data about the patients with rectal cancer treated with taTME were collected at the Affiliated Nanchong Central Hospital of North Sichuan Medical College from December 2018 to December 2019, including the clinical data and follow-up data. Postoperative recovery condition of the patients’ anal function and the affecting factors caused the occurrence of severe LARS after taTME were analyzed. The patients’ anal function within 1, 6, and 12 months after taTME were evaluated, and the evaluation tools were LARS scale and Wexner scale. The follow-up period was up to December 30, 2020.ResultsA total of 67 patients were completed preoperative and postoperative follow-up at 1, 6, and 12 months. In terms of anal function, within 1 month after taTME was the worst period in which the anal function was the worst among all the points of time evaluated (1.49±0.33, 10.28±0.64, 6.42±0.60, and 3.73±0.61, respectively), and there was time trend during the follow-up period (F=66.101, P<0.001). In the first year after taTME, the patient’s anal function was in a state of continuous recovery, and the differences between the three points of time at 1, 6, and 12 months after taTME and preoperative anal function were statistically significant (P<0.010). The results of multivariate analysis indicated that the distance between the anastomotic stoma and the anal verge was independent risk factor affecting the postoperative anal function of the patients with taTME at 1 month and 6 months (P<0.010).ConclusionsWith time going, the postoperative anal function of the patients with taTME can be recovered to a certain extent. The distance between the anastomotic stoma and the anal verge was the independent factor affecting the postoperative function of the rectal cancer patients received taTME.