Evaluation of anal function after surgery for rectal cancer

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.