Manometric appreciation of the anal sphincter function, when aiming for a "sphincter saving" procedure in patients with low rectal cancer

Anorectal manometry is one way of evaluating the patient´s quality of life, as it is an efficient way of assessing the anal function before and after neoadjuvant and/or surgical treatment. It is important to evaluate the function of the anal sphincter, as it can dictate the surgical treatment that is applied to the patient. The main issue that arises is the large variability of results, related to the operator-linked bias, as well as the different types of equipment that are used. Standardization is required. The studies in literature lack homogeneity, as some studies show there is a link between neoadjuvant therapy and anal incontinence, whereas others say there is no relation, while others even show the benefic effect on the short term of neoadjuvant radiation therapy on anal sphincter function. There is also the issue of long-term results and follow-up. In the instance of a "sphincter-saving" intervention, evaluation of the tonicity of the anal sphincter is important, as it can dictate between choosing a colorectal/coloanal anastomosis and realizing a terminal colostomy.