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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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.	張忠濤, 鄭民華, 姚宏偉, 等. 直腸癌經肛全直腸系膜切除專家共識及手術操作指南 (2017 版). 中國實用外科雜志, 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.	姚宏偉, 張忠濤, 鄭民華. 直腸癌經肛全直腸系膜切除中國專家共識及臨床實踐指南 (2019 版). 中國實用外科雜志, 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.	張浩, 張云生, 金雄偉, 等. 完全經肛單孔腹腔鏡全直腸系膜切除術治療直腸癌. 中國內鏡雜志, 2012, 18(4): 379-383.
6.	張鵬飛, 張凱. 腹腔鏡直腸癌經肛全直腸系膜切除術的臨床研究. 中國腫瘤外科雜志, 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.	龍飛, 歐陽軍, 陳向恒, 等. 腹腔鏡輔助經肛全直腸系膜切除術治療中低位直腸癌的臨床分析 (附 32 例報告). 中國內鏡雜志, 2020, 26(2): 11-18.
10.	靳鵬輝, 胡立冬, 李小飛, 等. 經肛門全直腸系膜切除術在中低位直腸癌中的療效及安全性的系統評價和 Meta 分析. 中國內鏡雜志, 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, 汪棟, 等. 直腸癌保肛術后短期生活質量研究現狀. 中華胃腸外科雜志, 2020, 23(4): 415-420.
15.	馬全民, 申占龍, 劉凡, 等. 經肛全直腸系膜切除與腹腔鏡全直腸系膜切除術后肛門功能的比較. 中華結直腸疾病電子雜志, 2018, 7(4): 337-341.
16.	葉志偉, 陳遠光, 胡明, 等. 直腸癌經肛內鏡全直腸系膜切除術對肛門功能影響的臨床研究. 中國普通外科雜志, 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.	侯曉華. 消化道高分辨率測壓圖譜. 北京: 科學出版社, 2014: 1-3.
21.	皮艷娜, 肖毅, 王智鳳, 等. 新輔助放化療對中低位直腸癌患者肛門直腸功能的影響. 中華醫學雜志, 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.	楊敏, 安果仙, 孫小兵, 等. 肛管內超聲對肛門直腸畸形術后肛門功能異常患兒的評估價值. 中華胃腸外科雜志, 2017, 20(11): 1306-1308.
26.	王永剛, 孫源. 術前三維肛管直腸腔內超聲檢查對肛瘺手術的療效分析. 中國普外基礎與臨床雜志, 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.	顧程. 動態 MRI 檢查結合 3D HR-ARM 技術對低位直腸癌保肛術后排便功能障礙的評價研究. 天津: 天津醫科大學, 2017.
29.	趙亞婧. 低位直腸癌保肛術聯合預防性回腸造口術后肛門直腸功能的影像評估. 天津: 天津醫科大學, 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.	曹蘭玉, 魏力, 王春梅. 直腸癌前切除綜合征評分量表的漢化及信效度評價. 中國實用護理雜志, 2013, 29(27): 69-72.
32.	閆晶晶, 牟紹玉, 譚人福, 等. 直腸癌低位前切除綜合征評分表中文版的實證研究. 解放軍護理雜志, 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.	趙曉堂, 戴雷, 盧云, 等. 4 種量表對低位直腸癌保肛患者的肛門功能的評價. 臨床醫學研究與實踐, 2016, 1(1): 1-3, 15.
35.	李卡, 黃明君, 謝娟, 等. 4 種量表評估直腸癌保肛病人術后 1 個月肛門功能的比較. 護理研究, 2013, 27(1): 93-94.
36.	陳思. 腸道術后患者腸蠕動功能恢復影響因素的研究. 長春: 吉林大學, 2016.
37.	魏汝玉. 研究腹腔鏡直腸癌經肛門全直腸系膜切除術 (TaTME) 與傳統腹腔鏡術式的療效//全國科研理論學術研究成果匯編 (二). 中國環球文化出版社、華教創新 (北京) 文化傳媒有限公司: 華教創新(北京)文化傳媒有限公司, 2020: 212-215.
38.	李仕興, 康安. 腹腔鏡直腸癌經肛門全直腸系膜切除術與傳統腹腔鏡術式療效對比. 現代消化及介入診療, 2018, 23(6): 782-785.
39.	徐忠發, 左文述, 劉奇. 現代肛腸腫瘤外科學. 濟南: 山東科學技術出版社, 1993: 258-260.
40.	劉思達, 劉棟, 段降龍. 腹腔鏡輔助經肛門全直腸系膜切除術與全直腸系膜切除術的臨床對比研究. 中華普外科手術學雜志 (電子版), 2020, 14(1): 42-45.
41.	竇若虛, 孫偉鵬, 羅雙靈, 等. 經肛全直腸系膜切除與腹腔鏡全直腸系膜切除術后患者的腸道功能: 基于隨機臨床研究的比較. 中華胃腸外科雜志, 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, Ko?ter 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. 張忠濤, 鄭民華, 姚宏偉, 等. 直腸癌經肛全直腸系膜切除專家共識及手術操作指南 (2017 版). 中國實用外科雜志, 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. 姚宏偉, 張忠濤, 鄭民華. 直腸癌經肛全直腸系膜切除中國專家共識及臨床實踐指南 (2019 版). 中國實用外科雜志, 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. 張浩, 張云生, 金雄偉, 等. 完全經肛單孔腹腔鏡全直腸系膜切除術治療直腸癌. 中國內鏡雜志, 2012, 18(4): 379-383.
6. 張鵬飛, 張凱. 腹腔鏡直腸癌經肛全直腸系膜切除術的臨床研究. 中國腫瘤外科雜志, 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. 龍飛, 歐陽軍, 陳向恒, 等. 腹腔鏡輔助經肛全直腸系膜切除術治療中低位直腸癌的臨床分析 (附 32 例報告). 中國內鏡雜志, 2020, 26(2): 11-18.
10. 靳鵬輝, 胡立冬, 李小飛, 等. 經肛門全直腸系膜切除術在中低位直腸癌中的療效及安全性的系統評價和 Meta 分析. 中國內鏡雜志, 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, 汪棟, 等. 直腸癌保肛術后短期生活質量研究現狀. 中華胃腸外科雜志, 2020, 23(4): 415-420.
15. 馬全民, 申占龍, 劉凡, 等. 經肛全直腸系膜切除與腹腔鏡全直腸系膜切除術后肛門功能的比較. 中華結直腸疾病電子雜志, 2018, 7(4): 337-341.
16. 葉志偉, 陳遠光, 胡明, 等. 直腸癌經肛內鏡全直腸系膜切除術對肛門功能影響的臨床研究. 中國普通外科雜志, 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. 侯曉華. 消化道高分辨率測壓圖譜. 北京: 科學出版社, 2014: 1-3.
21. 皮艷娜, 肖毅, 王智鳳, 等. 新輔助放化療對中低位直腸癌患者肛門直腸功能的影響. 中華醫學雜志, 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. 楊敏, 安果仙, 孫小兵, 等. 肛管內超聲對肛門直腸畸形術后肛門功能異常患兒的評估價值. 中華胃腸外科雜志, 2017, 20(11): 1306-1308.
26. 王永剛, 孫源. 術前三維肛管直腸腔內超聲檢查對肛瘺手術的療效分析. 中國普外基礎與臨床雜志, 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. 顧程. 動態 MRI 檢查結合 3D HR-ARM 技術對低位直腸癌保肛術后排便功能障礙的評價研究. 天津: 天津醫科大學, 2017.
29. 趙亞婧. 低位直腸癌保肛術聯合預防性回腸造口術后肛門直腸功能的影像評估. 天津: 天津醫科大學, 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. 曹蘭玉, 魏力, 王春梅. 直腸癌前切除綜合征評分量表的漢化及信效度評價. 中國實用護理雜志, 2013, 29(27): 69-72.
32. 閆晶晶, 牟紹玉, 譚人福, 等. 直腸癌低位前切除綜合征評分表中文版的實證研究. 解放軍護理雜志, 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. 趙曉堂, 戴雷, 盧云, 等. 4 種量表對低位直腸癌保肛患者的肛門功能的評價. 臨床醫學研究與實踐, 2016, 1(1): 1-3, 15.
35. 李卡, 黃明君, 謝娟, 等. 4 種量表評估直腸癌保肛病人術后 1 個月肛門功能的比較. 護理研究, 2013, 27(1): 93-94.
36. 陳思. 腸道術后患者腸蠕動功能恢復影響因素的研究. 長春: 吉林大學, 2016.
37. 魏汝玉. 研究腹腔鏡直腸癌經肛門全直腸系膜切除術 (TaTME) 與傳統腹腔鏡術式的療效//全國科研理論學術研究成果匯編 (二). 中國環球文化出版社、華教創新 (北京) 文化傳媒有限公司: 華教創新(北京)文化傳媒有限公司, 2020: 212-215.
38. 李仕興, 康安. 腹腔鏡直腸癌經肛門全直腸系膜切除術與傳統腹腔鏡術式療效對比. 現代消化及介入診療, 2018, 23(6): 782-785.
39. 徐忠發, 左文述, 劉奇. 現代肛腸腫瘤外科學. 濟南: 山東科學技術出版社, 1993: 258-260.
40. 劉思達, 劉棟, 段降龍. 腹腔鏡輔助經肛門全直腸系膜切除術與全直腸系膜切除術的臨床對比研究. 中華普外科手術學雜志 (電子版), 2020, 14(1): 42-45.
41. 竇若虛, 孫偉鵬, 羅雙靈, 等. 經肛全直腸系膜切除與腹腔鏡全直腸系膜切除術后患者的腸道功能: 基于隨機臨床研究的比較. 中華胃腸外科雜志, 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, Ko?ter 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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Current status and research progress in the assessment of anal function after transanal total mesorectal resection

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