Background and Objectives: Sphincter-saving surgical procedures for rectal
cancer have been legitimized if executed respecting the criteria of oncolog
ical radicalness. Our objective was to evaluate anal sphincteric continence
after rectal cancer surgery.
Methods: A detailed questionnaire regarding continence was administered to
3 groups of patients. Group 1 was composed of 9 patients treated with a hig
her (>4 cm), stapled colorectal anastomosis; the 9 group 2 patients were tr
eated with a low (less than or equal to 4 cm), stapled colorectal anastomos
is; the 9 group 3 patients underwent coloanal anastomosis.
Results: The results were evaluated about 3 years after surgery. Continence
was excellent in group 1 and very good in group 2. However, in group 3, we
observed diminished gas/feces discrimination, reduced ability to postpone
evacuation, and increased soiling and perianal rash.
Conclusions: Anal sphincteric continence was better after surgery with a hi
gh or low colorectal anastomosis than after coloanal anastomosis. (C) 2000
Wiley-Liss, Inc.