Evaluation of rectal and anal function after rectal cancer and anorectal disease surgery using a high-resolution anorectal manometry

2023 Fiscal Year Final Research Report

• Project/Area Number: 18K16332
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55020:Digestive surgery-related
• Research Institution: Jikei University School of Medicine
• Principal Investigator: Takeda Yasuhiro 東京慈恵会医科大学, 医学部, 助教 (40817136)
• Project Period (FY): 2018-04-01 – 2024-03-31
• Keywords: 高精細度直腸肛門内圧検査（HD-ARM） / 直腸癌 / 肛門疾患 / 直腸肛門機能 / 肛門機能障害

Outline of Final Research Achievements

Ano-rectal disorder following surgery for rectal cancer and anorectal disease has recently been the focus of much attention. This is the first study performed in Japan using high-resolution anorectal manometry (HR-ARM). We confirmed that the measured values in this study were not substantially different from those reported by overseas HR-ARM. In our study, we found that the lower rectal cancer patients had improved intra-anal pressure and Wexner score after CRT compared to before CRT. In the case of rectal prolapse, trans-abdominal fixation and the trans-anal approach showed no difference in the improvement of intra-anal pressure, but the Wexner score improved regardless of the difference.

Free Research Field

下部消化管外科

Academic Significance and Societal Importance of the Research Achievements

本邦で初めて256チャネルのHR-ARMを使用して肛門内圧検査を行い、参考値を作成し報告でき、過去の海外からの報告とくらべても大きな違いはないことが確認できた。従来のマノメトリーの経験や熟練した手技がなくてもHR-ARMは肛門内圧検査の安定した評価を行えることが確認できた。
また便失禁を伴う患者に対してHR-ARMを用いて骨盤底筋群のリハビリを行うことは３Dで構築された肛門管を患者と供覧可能であり、肛門を締めるイメージや意欲の向上につながり有用である。今後、HR-ARMなどの3D画像による視覚を用いたバイオフィードバック療法は有効な治療手段と期待される。