Anorectal Function after Anterior Resection for Carcinoma in Relation to the Length of the Residual Rectum

Akira Tsunoda, Miki Shibusawa, Manabu Takada, Noboru Yokoyama, Yohji Itoh, Masatoshi Kawamura, Mitsuo Kusano

Department of Surgery, School of Medicine, Showa University

A prospective study was carried out to assess functional restoration after anterior resection in patients with colorectal cancer. Clinical and manometric assessment was made in 20 patients with rectal cancer preoperatively and 3, 6 and 12 months after the operation. According to the length of the residual rectum (LRR), the patients were divided into two groups. LRR was under 5 cm in Group A, and it was 5 cm or over 5 cm in Group B. Eight patients who had sigmodiectomy were studied as a control. Results were correlated with the LRR and the time passed after the operation. The alteration of (bowel habits bowel movement frequency, discrimination between feces and gas, and urgency) were more evident in patients with an LRR shorter than 3 months after the operation, but they had improved by 12 months. In Group A, the anal canal resting pressure was significantly reduced 3 months after the operation, but it had returned to preoperative level by 12 months, while in Group B or control, it did not change significantly. The maximum to tolerable volume was significantly different among the three groups 3 months after the operation. It was lower in patients with a shorter LRR at each examination performed after the operation. These results suggest that anorectal function in patients who have an anterior resection is associated with the length of the residual rectum.

Key words
rectal cancer, anterior resection, anorectal function, length of residual rectum

Reprint requests
Akira Tsunoda Department of Surgery, School of Medicine, Showa University
1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142 JAPAN

Accepted
December 7, 1994

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