A hyperactive postprandial response in the neorectum--the clue to low anterior resection syndrome after total mesorectal excision surgery?

ABSTRACT

AIM: To investigate neorectal properties regarding biomechanical, sensory and postprandial response in patients after total mesorectal excision without neoadjuvant radiotherapy in groups of no low anterior resection syndrome (LARS) patients and major LARS patients. METHOD: Patients without LARS (n = 9) and patients with major LARS (n = 23) were investigated by multimodal rectal stimulation and standard anorectal physiological tests, and results were compared. RESULTS: Patients with major LARS had an increased postprandial response with a significant increase in pressure in the neorectum after a meal compared with patients without LARS (P = 0.017). No biomechanical differences could be detected. CONCLUSION: Low anterior resection syndrome seems to be caused by physiological changes due to neural damage more than structural changes in the ano-neorectum.