ANORECTAL FUNCTION AFTER PREOPERATIVE INTRALUMINAL BRACHYTHERAPY AND COLONIC J-POUCH ANAL ANASTOMOSIS FOR RECTAL-CARCINOMA

The effects of preoperative intraluminal brachytherapy on bowel functi on after anoabdominal rectal resection and colonic J pouch-anal anasto mosis were studied. The patients included eight not receiving irradiat ion (group 1), eight who received 30 Gy (group 2) and eight who receiv ed 80 Gy (group 3). Stool frequency and the incidence of soiling were significantly greater in group 3 than in the other groups. Anal restin g pressure was lower in group 3 during the study period but J pouch di stensibility was not reduced. The maximum tolerated volume, threshold volume and squeeze pressure were significantly lower in group 3 than i n the other groups in the early postoperative period These results sug gest that high-dose brachytherapy affects the anal sphincters and colo nic J pouch. A moderate dose of 30 Gy may be more suitable before rest orative anorectal surgery.