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- Title
Anal Function after Surgery for Low-Lying Rectal Cancer: Comparison of Mechanical and Hand-Sewn Coloanal Anastomosis.
- Authors
Matsunaga, Rie; Nishizawa, Yuji; Saito, Norio; Yokota, Mitsuru; Hayashi, Ryuichi; Ito, Masaaki
- Abstract
Background/Aims: Mechanical coloanal anastomosis (MCAA) or hand-sewn coloanal anastomosis (HCAA) are used in anus-preserving surgery for low-lying rectal cancer. Either method can be used if the lower edge of the tumor is 4-6 cm from the anal verge. The goal of this study was to evaluate differences in the anal function after MCAA or HCAA. Methods: The subjects were 305 consecutive patients with primary rectal cancer tumors situated 4-6 cm from the anal verge who underwent curative anus-preserving surgery between 2004 and 2013. Functional assessment was performed using a questionnaire at 3, 6, 12, and 24 months after stoma closure. Results: Of the 305 patients, 145 underwent MCAA and 160 underwent HCAA. The median distance of the tumor from the anal verge was 6.0 cm (range 4.0-6.0) in the MCAA group and 4.5 cm (range 4.0-6.0) in the HCAA group ( p < 0.001). A total of 192 patients (73%) responded to the 1-year questionnaire. The median Wexner score was 6 (range 0-17) in the MCAA group and 11 (range 0-20) in the HCAA group ( p < 0.001). Conclusions: Retention of anal function is feasible after both MCAA and HCAA. MCAA may contribute to better postoperative anal function compared to HCAA.
- Subjects
ANORECTAL function tests; ONCOLOGIC surgery; ENDOSCOPIC surgery; LAPAROSCOPIC surgery; ONCOLOGY
- Publication
Digestive Surgery, 2017, Vol 34, Issue 6, p469
- ISSN
0253-4886
- Publication type
Article
- DOI
10.1159/000456080