Disorder of Anorectal Function after Sphincter-Saving Operation for Rectal Cancer and the Therapy -Motility of the Oral Side of Anastomosis-

Masanori Tada, Ichirou Matsukura, Eiich Yabata, Satoshi Okabe, Mitsuo Endo

The First Department of Surgery, Tokyo Medical & Dental University

The purpose of this study was to determine the effect of the condition of the oral side of the anastomosis on the anorectal function after a sphincter-saving operation for rectal cancer. We used a four-channel microtip pressure transducer catheter producted by Miller Corp. The sensors were placed at 0, 5, 10 and 15 cm from the tip. The catheter was inserted and the sensors were placed at 5, 10, 15 and 20 cm from the anal verge. The pressure of each location was recorded for 90 minutes. Conventional anorectal manometry and clinical questionnaires were also used. We divided the patients into 2 groups according to the clinical score obtained by the questionnaire, a good function group and a poor one. To analyze these data, we changed each pressure into scores of 5 degrees. When the control group, the good group and the poor group were compared with each other, significant differences were found in the length of the stump, the number of postoperative months, compliance and the pressure score. A significant correlation was found between the total pressure score and clinical score. anorectal function was mainly affected by the number of postoperative months, the length of the stump, rectal compliance and anal sensation. In addition to those factors, a stable condition of luminal pressure and movement in the oral side of the anastomosis is important for good anorectal function after surgery.

Key words
anorectal function, sphincter-saving operation, rectal cancer, intraluminal pressure and movement, oral side of anastomosis

Reprint requests
Masanori Tada First Department of Surgery, Tokyo Medical & Dental University
1-5-45 Yushima, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
January 10, 1996

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