J.Jpn. Surg. Soc.. 83(9): 1004-1007, 1982

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Report on the annual meeting

FECAL CONTINENCE AFTER SPHINCTER-SAVING RESECTIONS FOR CARCINOMA OF THE RECTUM

Anorectal manometric study and clinical assessment were performed to evaluate the function of the preserved anorectum in 38 patients who have had sphincter-saving resections for carcinoma of the rectum (29 patients with low anterior resection, 2 with Welch type abdominoanal resection, 6 with Turnbull or Bacon type pull-through operation, 1 with abdomino-transsacral resection). The manometric study was also performed in 7 patients who had undergone right hemicolectomy as a control group.
In the manometric study, the patients who had undergone low anterior resection exhibited the same anorectal pressure profile with a high pressure zone in the anal canal as did the control subjects and their anorectal pressure difference was 68.0±9.7cmH₂O (SE) which was not significantly different from those of the control subjects. With regard to anorectal reflex, all of the patients whowed a typical fall in anal canal pressure corresponding to rectal distension. In the two patients who had undergone Welch type abdomino-anal resection showed an anorectal reflex. On the contrary, only one of the 3 patients with Turnbull and one of the Bacon type pull-through operation showed the anorectal reflex.
From these results the patients with low anterior resection achieved clinically and manometrically the best anal control in these sphincter-saving operations, and next the functional results of Welch type abdomino-anal resection and Turnbull type pull-through operation were better than that of Bacon type pull-through operation.

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