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Title: The value of the anal sphincters electromyography for the anorectal function assessment after anterior resection of the rectum

Abstract:

Approximately 70 % of patients after low anterior resection of rectum report embarrassing rectoanal dysfunctions (in form of various degrees of faecal incontinence) so-called low anterior resection syndrome (LARS). Disturbances in sphincters innervation as an implication of sugery can play the main goal in the etiology of LARS. The primary aim was to assess the influence of oncological treatment on motor functions evaluated with superficial multi-channel electromyography (sEMG) and evaluation of influence of the extend of resection of the rectum on spatio-temporal sEMG registration with consideration of time trends. The following secondary aim was: determination of the correlation between sEMG (RMS, MNF) parameters and the results of anorectal manometry (MRP, MSP, RAIR) with the degree of faecal incontinence measured in FISI range. A total of 35 rectal cancer patients (M:F: 28/7; age 6511.4) were included into the study. sEMG parameters, manometric measures and clinical evaluation (FISI) were performed during qualification for the treatment and 1, 6 and 12 months after surgery. The patients qualified to pre-operative radiotherapy were also examined before and 6 days after radiotherapy. A Three ring (48 channel) anorectal probe connected with 16 channels EMG–amplifier 16 II BF was used for sEMG recording (OT Bioelettronica, Torino, Italy). Two independent measures were assessed in rest and during maximal contraction of the EAS. The analysis was performed within the identified groups (RR – all operated, AR – Anterior Rectal Resection, LAR – Low Anterior Rectal Resection, RTH – Radiotherapy) and also between AR and LAR groups. Significant change of sEMG parameters was observed. The RMS reduction and as well as MNF increase were observed after the surgery in RR group. In subsequent periods of evaluation (6 and 12 months) increased values of sEMG parameters were revealed which correlate with manometric measures. There were statistically significant differences concerning sEMG parameters and manometry between LAR and AR groups. Electromyographic recordings correlate both with results of anorectal manometry and functional dynamic tests, but also with the intensification of faecal incontinence measured with FISI scale. Significant influence of radiotherapy on motor action of anal sphincters was revealed. The obtained results allow to evaluate sEMG as a reliable method of evaluation of functional condition of the sphincters complex both in relation to genesis of their dysfunction (neurogenic) and in prognostic context – that is regression of LARS symptoms in specific time.

Level of degree:

2 - studia doktoranckie

Degree discipline:

chirurgia

Degree grantor:

Wydział Lekarski

Promoter:

Roman M. Herman

Date issued:

2008

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:867

Call number:

ZB-109407

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Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

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Last modified:

Nov 19, 2019

In our library since:

Nov 21, 2012

Number of object content hits:

10

Number of object content views in PDF format

10

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/867

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ZB-109407 Nov 19, 2019
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