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Session: ePoster: Pelvic Floor 1 (Sun8)

EP337 - Manometric Evaluation and Clinical Response to Anal Electroestimulation in Patients with LARS

Sunday, May 11, 2025
8:54 AM – 8:59 AM PT
Location: Monitor 8. Sails Pavilion, Upper Level

    Author(s)

  • AV

    Angie E. Vargas Rodriguez, n/a

    Dr
    Hospital General de México
    mexico, Distrito Federal, Mexico

    Disclosure information not submitted.

  • Sharon J. Sanchez Lara, MD (she/her/hers)

    Dr
    Hospital General de México
    Toluca, Mexico

    Disclosure information not submitted.

  • CL

    Carlos Alberto López-Bernal (he/him/his)

    Dr
    HGM
    mexico, Distrito Federal, Mexico

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • ePoster Presenter(s)

  • Jeziel Karina Ordonez Juarez (she/her/hers)

    Resident
    Hospital general de México
    Universidad Nacional Autónoma de México
    Mexico, Mexico

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • CV

    Carolina Vázquez Iñiguez, n/a

    Dr
    Hospital General de México
    Guadalajara, Jalisco, Mexico

    Disclosure information not submitted.

    • Senior Author(s)

  • JV

    JUAN ANTONIO VILLANUEVA HERRERO, Sr., n/a

    Program director
    Hospital General de Mexico
    Mexico, Distrito Federal, Mexico

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • BJ

    Billy Jimenez Bobadilla, n/a

    Doctor
    Hospital General de Mexico
    Ciudad de Mexico, Distrito Federal, Mexico

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Carlos Alberto López-Bernal: This individual has no financial relationships with ineligible companies.
Jeziel Karina Ordonez Juarez: This individual has no financial relationships with ineligible companies.
JUAN ANTONIO VILLANUEVA HERRERO, n/a, Sr.: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: The high prevalence of colorectal cancer has led to the adoption of sphincter-preserving surgical techniques, such as low anterior resection with total mesorectal excision, which reduce recurrence and increase survival rates. However, there are sequelae, with low anterior resection syndrome (LARS) being present in 80-90% of cases. Common symptoms of LARS include fecal incontinence, defecatory urgency, incomplete evacuation, tenesmus, constipation, increased frequency of bowel movements, and pain. The objective of this study is to describe the manometric findings in patients with LARS, as well as the clinical improvement based on the LARS score following endoanal electrostimulation therapy (EEEA).

Methods/Interventions: This is a retrospective, cross-sectional, observational, and descriptive study involving 23 postoperative patients who underwent primary anastomosis or intestinal restoration from a protective stoma and received at least six sessions of endoanal electrostimulation therapy (EEEA).

Results/Outcomes: Of the 23 patients, 13 (56.5%) were women and 10 (43.5%) were men, with ages ranging from 26 to 77 years (mean age 55.35 years). Twenty two patients (96%) had a history of rectal cancer and 1 (4.3%) had familial adenomatous polyposis. The majority (73.91%) underwent low anterior resection with total mesorectal excision and laparoscopic colorectal anastomosis. Thirteen patients (56.5%) received neoadjuvant chemoradiotherapy.
Regarding LARS phenotypes, 20 patients (87%) exhibited predominant fecal incontinence, while 3 (13%) had predominant pain. The initial LARS score ranged from 12 to 42 points, with a mean score of 33.95 points (indicating severe LARS).
Manometric findings included: mean resting pressure ranging from 9.80 to 116.80 mmHg (mean 45.33 mmHg), maximum contraction pressure from 23.7 to 181.6 mmHg (mean 96.5 mmHg), and contraction duration from 4.1 to 30 seconds (mean 13.17 seconds). The first sensation occurred at 20 to 180 cc (mean 49.7 cc), first desire at 20 to 170 cc (mean 71.5 cc), and intense desire at 20 to 180 cc (mean 113.6 cc). Hypotonia was found in 11 patients (47.8%), hypocontractility in 8 (34.7%), and hypersensitivity in 8 (34.7%). Additionally, 8 patients (34.78%) showed anatomical alterations on endoanal ultrasound.

Conclusion/Discussion: Endoanal electrostimulation (EEEA) is an effective intervention for improving the symptoms of low anterior resection syndrome (LARS) in patients who have undergone primary anastomosis or intestinal restoration. The manometric findings suggest significant alterations in anorectal function, and the notable improvement in the LARS score following therapy indicates a positive impact on the quality of life of these patients. These results support the implementation of EEEA as a valuable therapeutic option to address the functional sequelae of surgical treatment for colorectal cancer.