Defecatory malfunction caused by motility disorder of the neorectum after anterior resection for rectal cancer.
BACKGROUND
The correlation between postoperative defecatory status after anterior resection for rectal cancer and physiologic neorectal motility has not been well delineated.


METHODS
Sixty patients who underwent anterior resection were examined. Motility of the neorectum was examined with 4-sensor intraluminal pressure monitoring, and segmental colonic transit time was determined with radiopaque Sitzmarks (Konsyl, Fort Worth, Texas) capsules.


RESULTS
Twenty-eight patients experienced loss of propagated contraction waves down to the neorectum, which was closely correlated with a prolonged transit time through the neosigmoid colon and neorectum. In 26 patients, minor spastic waves were observed at the neorectum, which did not correlate well with the loss of propagated waves. The loss of propagation and the existence of spastic waves were significantly correlated with urgency of defecation and multiple evacuations. The latter was also associated with major soiling and with patients' assessments of impaired defecatory function.


CONCLUSIONS
The physiologic motility of the neorectum is one of the factors responsible for postoperative defecatory function after anterior resection for rectal cancer.
Iizuka
Isamu
I
Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba, 260-8670 Japan.
Koda
Keiji
K
Seike
Kazuhiro
K
Shimizu
Kimio
K
Takami
Yoji
Y
Fukuda
Hiroyuki
H
Tsuchida
Daisuke
D
Oda
Kenji
K
Takiguchi
Nobuhiro
N
Miyazaki
Masaru
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001187:Artificial Organs / Q000009:adverse effects*; D003106:Colon / Q000502:physiology; D003672:Defecation; D005260:Female; D005769:Gastrointestinal Motility; D005772:Gastrointestinal Transit; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000502:physiology*