[Functioning disorders after surgery of rectum cancer--(1). Functioning prognosis of defecation disorder following anus preserving operation]

Thirty-three anus-preserved rectal cancer patients with anterior resection or low anterior resection were asked about their postoperative defecation conditions with questionnaires after a more than one and half year postoperative period. Beforehand the residual anorectum length was defined by subtracting the length of the specimen AW and 1.5 cm as suturing width from the length of the anal verge through the anal tumor margin during romanoscopic examination. Involuntary soiling frequently occurred in the cases with a less than 9 cm residual anorectum, in the female cases and in the cases associated with lateral lymph node dissection. But these factors have no definite relation to the time of disappearance of involuntary soiling. Half of the cases were normalized in 2 years, and 80% in 3 years. Frequent bowel movement occurred in a high percentage of cases, especially in the cases with short residual anorectum or with lateral lymph node dissection. Frequency of defecation decreased from 8-9/day up to 6 months later, to 5/day up to one year later, and 2-3/day up to 6 years later. Improvement of the above-mentioned condition was slightly delayed in the less than 6 cm residual anorectum group and in females, but not in the lateral lymph node dissection group. Anastomosis insufficiency caused a delay in recovery from involuntary soiling.