Le sequele funzionali dopo chirurgia del retto basso


COD: 03_2009_193-198 Categorie: ,

Carlo Pala, Fernando Serventi, Panagiotis Paliogiannis, Emilio Trignano, Federico Attene, Fabrizio Scognamillo, Mario Trignano

Ann. Ital. Chir., 2009; 80: 193-197

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INTRODUCTION: The treatment of colorectal cancer has changed radically in the last decades. Due to the great advances
it is now often possible to subject patients to oncological radical treatments without applying to highly aggressive surgery,
such as the Miles abdomino perineal resection, which requires a definitive colostomy. So nowadays we more and more
apply to anterior resection of the rectum. Some recent studies about quality of life in patients who underwent anterior
resection of the rectum focalized their attention on postoperative functional sequels. In particular incontinence, constipation,
obstructed defecation and urgency are some of the symptoms which define the anterior resection syndrome, which
can be efficiently treated by electrostimulation and biofeedback.
MATERIALS AND METHODS: A prospective study on 61 patients who underwent between 2002 and 2007 anterior resection
of the rectum with total mesorectal excision for adenocarcinoma, has shown symptoms of anterior resection syndrome
in 14 patients. Succeeding treatment with sphincter electrostimulation and biofeedback has shown improvement in all
patients and complete resolution of the anterior resection syndrome in 10 patients who showed a great compliance and
a steady improvement on quality of life.
DISCUSSION AND CONCLUSIONS: Rehabilitative treatment with electrostimulation and biofeedback can sensibly reduce
symptoms of anterior resection syndrome. An accurate manometric functional assessment is necessary before starting treatment
with electrostimulation and biofeedback.


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