title: Which is the preference of choice either life with a stoma or evacuatory disorder following rectal cancer surgery?
abstract: OBJECTIVE
  Low anastomosis with covering stoma is the standard operation for low rectal carcinoma. Some patients experience severe anorectal disorder, which makes us consider whether stoma closure should be performed or not. There was no comparative study between life with a stoma and life with evacuatory disorder.
  
  
  METHODS
  Covering stoma was closed at 4 to 6 months after ultra-low anterior resection. Forty-five patients were evaluated by questionnaire in terms of their bowel evacuation and anorectal manometry before ultra-low anterior resection and 6 months after stoma closure. They were also questioned about their subjective preference regarding the life before and after stoma closure.
  
  
  RESULTS
  After stoma closure, frequency of daily bowel movement was significantly increased up to 5 times (range 2-15). Incontinence score was also significantly worsened from 0 to 8, postoperatively. All patients complained of any influence in their social life. Ninety-three percent (42/45) of the cases were dissatisfied with evacuation, postoperatively. Eighty-nine percent (40/45) of the cases had postoperative evacuatory disorder defined by the present study. Under these backgrounds, all patients replied that evacuation from the anus was superior to life with a stoma even during postoperative evacuatory disorder status.
  
  
  CONCLUSIONS
  Even when patients had evacuatory disorder, they preferred life without a stoma according to their subjective opinion.
authors.affiliation: Department of Surgery, Kyorin University, School of Medicine, Tokyo, Japan. hmatsu@ks.kyorin-u.ac.jp
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Matsuoka
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Masaki
authors.forename: Takaaki
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Kazunori
authors.initials: K
authors.lastname: Sato
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Mori
authors.forename: Masanori
authors.initials: M
authors.lastname: Sugiyama
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Atomi
mesh_terms: D000368:Aged; D002755:Choice Behavior; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012004:Rectal Neoplasms / Q000601:surgery*; D054047:Surgical Stomas