J.Jpn. Surg. Soc.. 83(9): 1024-1028, 1982

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Report on the annual meeting

POSTOPERATIVE EVALUATION OF PELVIC ORGAN FUNCTION, AND THE CRITERIA FOR OPERATIVE INDICATION BASED ON SELECTIVE ABDOMINAL ANGIOGRAM

In cases of fecal incontinence following radical operation for rectal cancer, almost 80% improved within two years and urinary disturbance disappeared in almost all cases within a year. Cases undergoing pull-through anastomosis procedures especially showed a tendency for anal incontinence to persist.
Thirty-seven male patients aged less than 60 were evaluated for sexual dysfunction. Eleven men became impotent, and abnormal ejaculation was recognized in 13 men. This problem should be studied carefully corelated to details of the operative procedure in future.
In terms of preservation of anal sphincter, the most ideal operation for rectal cancer is anterior resection, however it is not indicated in advanced cancer. If cancer invasion were suggested in the rectal wall by abnormal middle hemorrhoidal angiogram findings, abdomino-perineal resection should be performed despite the existence of a normal anal canal, since lateral dissection will be sufficient. Selective angiography can show small lesions below the peritoneum preoperatively, which are occasionally missed during operation.
We emphasize the value of middle hemorrhoidal angiogram to determine the indication for anterior resection.

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