The reported effects of sphincter-saving operations on the internal anal sphincter (IAS) are contradictory. Goligher et al.  showed a very low resting pressure in patients with a short rectal stump (6 cm or less) corresponding to the levels recorded in patients with idiopathic faecal incontinence. In contrast, recent studies have demonstrated only a slight reduction or even normal resting pressure both after LAR and transanal resection. The external sphincter, responsible for voluntary contraction, appears to be unaffected after these procedures.
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