Intraoperative neuromonitoring in rectal cancer surgery: a systematic review and meta-analysis

Int J Colorectal Dis. 2021 Jul;36(7):1385-1394. doi: 10.1007/s00384-021-03884-z. Epub 2021 Mar 8.


Purpose: The aim of this study is to evaluate the role of pelvic intraoperative neuromonitoring (pIONM) in rectal cancer surgery.

Methods: A systematic review of the literature and a meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions.

Results: Overall, nine studies were identified. Quantitative analysis was performed only in three trials. Bilateral pIONM improved postoperative anorectal and urogenital functional outcomes. However, unilateral pIONM displayed a significant effect only on erectile function (p = 0.001).

Conclusions: Our findings suggest a positive effect of pIONM on postoperative functional outcomes and quality of life after rectal cancer surgery. Due to several limitations, further trials are required in order to elucidate the exact role of pIONM.

Keywords: Fecal incontinence; Neuromonitoring; Pelvic; TME; Urogenital dysfunction.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Male
  • Pelvis
  • Quality of Life*
  • Rectal Neoplasms* / surgery
  • Rectum / surgery