title: Treatment of low rectal cancers and pre-cancerous lesions with proctectomy and pullthrough colo-anal anastomosis.
abstract: There are conflicting reports on the functional outcome of the sphincter after a pullthrough colo-anal anastomosis. We report a series of 21 consecutive patients treated with this technique. Thirteen patients underwent operation for cancer, seven for villous adenoma and one for benign stricture. They were interviewed for stool frequency, continence and gas/stool discrimination, and the clinical records were reviewed. At 19 +/- 9 months (mean +/- SD) post-operation, 15 patients (71%) were perfectly continent, five (24%) had minor impairment in continence, and one (5%) was incontinent. Thirteen patients (62%) had two or less bowel actions per day, six (28%) had three to five bowel actions, and two (10%) had more than five bowel actions. Eighteen patients (85%) had normal gas/stool discrimination, two (10%) had partial but improving discrimination, and one (5%) was unable to discriminate. There was no local recurrence in any of the cancer patients. This series corroborates the findings of other investigators who report good functional outcome with the pullthrough technique.
authors.affiliation: Department of Surgery, Alexandra Hospital, Singapore.
authors.forename: A S
authors.initials: AS
authors.lastname: Pang
authors.forename: D P
authors.initials: DP
authors.lastname: Baldinger
authors.forename: K K
authors.initials: KK
authors.lastname: Lee
authors.forename: W H
authors.initials: WH
authors.lastname: Schraut
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical; D003106:Colon / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011230:Precancerous Conditions / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery