ASSESSMENT OF PELVIC FLOOR FUNCTION IN PATIENTS AFTER LOW ANTERIOR RESECTION FOR RECTAL CANCER USING SIMPLE DEFECOGRAPHY

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  • HIROSE Kiyotaka
    Department of Surgery, Koshigaya Hospital, Dokkyo University School of Medicine
  • OYA Masatoshi
    Department of Surgery, Koshigaya Hospital, Dokkyo University School of Medicine
  • ISHII Yuji
    Department of Surgery, Koshigaya Hospital, Dokkyo University School of Medicine
  • ISHIKAWA Hiroshi
    Department of Surgery, Koshigaya Hospital, Dokkyo University School of Medicine

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  • 直腸癌に対する低位前方切除術後の骨盤底形態・動態の簡易defecographyによる検討

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Abstract

The pelvic floor function was assessed using simple defecography performed following routine barium enema examination in 19 patients who had undergone a low anterior resection (LAR) for a rectal cancer. In comparison with 19 age- and-sex matched control subjects, the patients after LAR had lower pelvic floor and perineal positions during plevic floor contraction. Patients who were judged to have a poor postoperative anal function because of frequent bowel movements and frequent episodes of fecal soiling had a significantly more obtuse anorectal angle than those who were judged having a good postoperative anal fucntion. Patients having an anastomosis very close to the anal margin had a more obtuse anorectal angle than the others with a significant difference. Patients whose pelvic autonomic nerves were completely preserved had a more acute anorectal angle and a higher pelvic floor position than those whose pelvic autonomic nerves were partially or totally excised. These results suggest that an atonic pelvic floor caused by the dissection around the rectum and the operative maneuver to the pelvic floor during LAR is one of the mechanisms of postoperative anal dysfunction.

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