LONG-TERM FUNCTIONAL RESULTS OF COLOANAL ANASTOMOSIS FOR RECTAL-CANCER

In a survey of patients treated with coloanal anastomosis for rectal c ancer, 81 of 90 eligible patients responded to a questionnaire evaluat ing current anorectal function. Time from operation to assessment rang ed from 1.3 to 12.3 years (median: 4.3 years). The median stool freque ncy was two per day; 22% of patients reported four or more stools per day. In the patients surveyed, fecal continence was complete in 51%, i ncontinence to gas only in 21%, minor leak in 23%, and significant lea k in 5%. Complete evacuation of the neorectum was problematic in 32%. Overall function was excellent in 28%, good in 28%, fair in 32%, and p oor in 12%. The impact of treatment variables on functional outcome wa s assessed by univariate and multivariate analyses. No surgical techni que correlated with improved or impaired outcome. Time since surgery ( reduced stool frequency) and use of postoperative adjuvant radiotherap y (increased stool frequency, increased difficulty with evacuation) di d appear to influence functional outcome. The conclude that the functi onal results of coloanal anastomosis are good but not optimal. Continu ed investigation of the effects of surgical technique and adjuvant the rapy is warranted.