[Bowel control of anus-preserving operation for low rectal cancer in elderly patients over 75 years].
OBJECTIVE
To evaluate the bowel control of the anus-preserving operation for elderly patients over 75 years with low rectal cancer.


METHODS
Thirty-nine elderly patients over 75 years with low rectal carcinoma (4-7 cm from anal verge) were treated during the study period. The patients were divided into different groups according to the surgical procedures and anastomotic locations. The bowel control and patients satisfaction were compared.


RESULTS
The time of recovering normal defecation frequency was (9.8+/- 2.9) months. There were no differences in bowel control and anorectal manometric findings between the lower anastomosis group and super-lower anastomosis group, the lower anastomosis group and anorectal anastomosis group. The patients in anorectal anastomosis group displayed significantly better bowel control and anorectal manometric findings than those in the super-lower anastomosis group (P< 0.05). The time of recovering normal defecation frequency in colonic J-pouch-anal anastomosis group was (7.7+/- 1.7) months, shorter than (10.6+/- 2.8) months in direct anastomosis group (P< 0.01). The complication rate of I degree incontinence was 36.1%, but there was no difference between the two groups. The anorectal manometric findings were better in J-pouch-anal anastomosis group than those in direct anastomosis group (P< 0.05).


CONCLUSIONS
Colonic J-pouch-anal anastomosis for lower rectal carcinoma can significantly improve the bowel control in a short term without increasing the complication rate.
Lu
Bing
B
Department of Colorectal Surgery, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China. lubingwj@hotmail.com
Fu
Chuan-gang
CG
Liu
Lian-jie
LJ
Liu
Yu-xiang
YX
Xing
Jun-jie
JJ
Meng
Rong-gui
RG
Jin
Guo-xiang
GX
Yu
De-hong
DH
D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical; D003672:Defecation; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D011184:Postoperative Period; D012004:Rectal Neoplasms / Q000503:physiopathology* / Q000601:surgery