Using transanal irrigation in the management of low anterior resection syndrome: a service audit

Low anterior resection syndrome (LARS) is a collection of symptoms that can occur as a result of a low anterior resection for bowel cancer. Transanal irrigation (TAI) can be used to manage these symptoms. This article describes a retrospective audit of 15 patients who were using TAI to manage symptoms of LARS. The aim of the audit was to ascertain whether the use of TAI improved outcomes for these patients. The data suggest that TAI has reduced both the frequency of bowel movements and episodes of faecal incontinence. Those patients using higher volumes of water seem to have experienced more benefit than those patients using lower volumes of water. These findings are consistent with current literature around TAI for LARS and suggest research into optimum volume of water would be beneficial.

On the question of jejunum sarcomas

Intestinal sarcoma is a relatively rare disease. It occurs much less frequently than cancer. According to Mikulich, for example, there were only 5 sarcomas per 100 cases of bowel cancer (except recti). The intestine, in comparison with other organs, is also not often affected by sarcoma. According to Nagel's notes on 247 sl. sarcomas, intestinal sarcomas were observed in 3 cases (1%)- Surgical literature is not rich in works devoted to intestinal sarcomas. Korner and Furbank collected 175 sarcomas of the digestive tract before 1907, of which 65 were localized in the small intestine. Sreese in 1914 was able to take 99 sl. intestinal sarcomas. The Russian literature on the issue of intestinal sarcoma has the works of Bondarev, Favorsky, Peacemakers and Punin. Intestinal sarcoma is more common in men (80% according to Noorden) This disease is mainly observed at a young age, from 20 to 30 years (Peacemakers, Bondarev), 30-40 (Corner, Madelung). However, sarcomas also occur at an older age. Of all parts of the intestine, sarcoma is most often found in the small intestine. So Korner and Furbank mark 65 sarcomas of the small intestine, 20 sarcomas of the blind and 11 other parts of the colon. According to Liebman, out of 50 cases in 15 sl. localization was in the 12-digit, in 18 in the skinny, in 14 in the iliac and the rest in other parts of the digestive tract. According to Staemmler (1924), for 184 cases of sarcoma of the small intestine, localization in the jejunum is indicated in 44 cases.