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 oncological 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 higher (>4 cm), stapled colorectal anastomosis; the 9 group 2 patients were treated with a low (less than or equal to 4 cm), stapled colorectal anastomosis; 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 high or low colorectal anastomosis than after coloanal anastomosis. (C) 2000 Wiley-Liss, Inc