J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 4351KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 81(4): 330-337, 1980

Original article

A MANOMETRIC ASSESSMENT OF POSTOPERATIVE CONTINECE IN RECTAL CANCER PATIENTS WITH SPHINCTERSAVING RESECTIONS

First Department of Surgery, Kyoto Prefectural University of Medicine
*) Department of Surgery, Kobe Central Social Insurance Hospital

Naomi Iwai, Kyozo Hashimoto, Jun Yanagihara, Shuhei Ogita, Bunzo Nishioka, Yoshihiro Fujita, Susumu Majima, Junzo Ochiai*)

Functional results following sphincter-saving resections in rectal cancer patients were assessed on a clinical basis and by manometric study. The anorectal manometric study was done with open-tip method and constant infusion (10 ml/h) system. 20 patients (12 with low anterior resection, 1 with abdomino-transsacral resection and 3 with Bacon type pullthrough operation) were personally interviewed,and had manometric study preoperatively and postoperatively to evaluate fecal continence.
Twelve patients in the good results had a marked high pressure zone in the anal canal and normal pattern of anorectal reflex following low anterior resection. 4 patients with anastomotic leaks in the poor results had no marked high pressure zone in the anal canal and the anorectal reflex was not observed on 2 months postoperative day. However, as the clinical assessment improved, a marked high pressure zone in the anal canal and normal pattern of anorectal reflex were observed again on 7 months postoperative day. 1 patients with abdomino-transsacral resection had no high pressure zone in the anal canal and showed an absence of anorectal reflex in spite of the fair result. 3 patients with Bacon type pull-through operation had ah igh pressure zone in the anal canal, however the anorectal reflex was not observed in these patients.
Anorectal manometric study proved to be useful for an objective assessment of postoperative continence in rectal cancer patients with sphincter-saving resections. Because, the manometric study reflected well the physiologic status of postoperative anorectum. From manometrical points of view the presence normal anal pressure at rest as well as adequate anorectal pressure difference was found to be more inevitable for retaining fecal continence than the anorectal reflex.

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