Function of the distal rectum after low anterior resection for carcinoma.
From a personal series of 232 anterior resections performed over 10 years, functional results have been analysed in two specific groups of patients: those with anastomoses 3 cm (n = 26) and 6 cm (n = 42) from the anal verge. In both groups low anterior resection had been performed with total mesorectal excision. Function was assessed in four categories: bowel frequency, ability to distinguish flatus from faeces, ability to defer defaecation, and frequency of soiling. Independent analysis of the 3 cm group showed a significant deterioration in function in each category after operation. The ability to defer defaecation and the frequency of soiling were unchanged after operation in the 6 cm group, and these functions were significantly better than in the 3 cm group. On the basis of these results, patients undergoing low anterior resection with total mesorectal excision should benefit from the preservation of a short segment of distal rectum, provided that the distal resection margin is not compromised.
Karanjia
N D
ND
Colorectal Research Unit, Basingstoke District Hospital, Hampshire, UK.
Schache
D J
DJ
Heald
R J
RJ
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000503:physiopathology; D000714:Anastomosis, Surgical; D003672:Defecation / Q000502:physiology; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005414:Flatulence / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000503:physiopathology* / Q000601:surgery; D012677:Sensation