American journal of surgery
-
Anorectal function was studied in 55 patients undergoing low anterior resection for rectal adenocarcinoma. Patients were examined preoperatively and 3 months postoperatively by anorectal manometry and standardized interview. Postoperatively, the patients showed, in general, an impairment of anorectal functions. ⋯ However, the two groups with the level of the anastomosis less than or equal to 6 cm (n = 27, range 3 to 6) and more than 6 cm (n = 28, range 7 to 10) above the anal verge showed no differences in manometric values, stool frequency, or fecal continence assessed by the interview. No correlation was found between the level of the anastomosis and manometric values and between the level of the anastomosis and stool frequency (regression analysis = not significant). We concluded that anorectal function after anterior resection and low colorectal anastomosis are not influenced by the remaining length of the rectum but by the surgical trauma to the sphincter and its innervation.
-
Metastatic neuroendocrine malignancies frequently cause incapacitating endocrinopathies, and metastases predominant in the liver. Hepatic resection of metastases from such tumors is attractive because the natural history of neuroendocrine tumors is protracted, clinical severity of the endocrinopathy correlates with tumor volume, and local and intrahepatic growth characteristics often allow complete resection. ⋯ Hepatic resection for metastatic neuroendocrine malignancies is safe, provides effective palliation, and probably prolongs survival.