Prospective study of the proctographic and functional consequences of transanal endoscopic microsurgery

A prospective study of clinical, manometric and proctographic results in 36 patients presenting for transanal endoscopic microsurgery was performed. Anorectal manometry showed no difference in maximal squeeze pressure before and 12 months after operation, but resting pressures were lower after surgery (mean(s.e.m.) preoperative 86.1(27.6) mmHg versus postoperative 67.2(23.2)mmHg, P<0.05). The rectoanal inhibitory reflex was lost in a significant group of patients (reflex present in 34 of 36 patients before operation and in 27 of 36 12 months after operation, P<0.05). Proctography, manometry and questionnaire showed preserved function of most modalities 12 months after operation such that if objective function was impaired clinical function was adequate.