Physiologic status of the anorectum following sphincter-saving resection for carcinoma of the rectum.
The physiologic status of the anorectum after low anterior resections or pull-through operations of the rectum was evaluated clinically and by manometric studies. It was demonstrated that the presence of a normal anal resting pressure and an anorectal reflex were important to achieve postoperative continence after sphincter-saving operations. In patients with anastomotic leaks and poor function, a marked high-pressure zone in the anal canal and an anorectal reflex were not found, but as local inflammation resulting from the anastomotic leak disappeared, these parameters returned to normal. A normal anorectal reflex was found in one of three patients after Bacon-type pull-through operations, but the remaining two showed an increase of anal canal pressure during colonic distention. These results indicate that an elevation of anal-canal pressure in response to colonic distention plays a significant role in fecal continence at the time of "a sense of urgency" if internal sphincter function is impaired.
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000503:physiopathology* / Q000601:surgery; D003672:Defecation; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008722:Methods; D008875:Middle Aged; D011312:Pressure; D012004:Rectal Neoplasms / Q000503:physiopathology / Q000601:surgery*; D012007:Rectum / Q000503:physiopathology* / Q000601:surgery