대한대장항문학회

Purpose : Low anterior resection, irrespective of anastomotic technique, may be<br>associated with frequent bowel movement and other bowel management difficulties. The<br>aim of this study was to access the anorectal function after low anterior resection of<br>the rectal cancer. Methods : We studied 28 patients who had mid and low rectal cancer<br>(average 8.3 cm above the anal verge) had undergone low anterior resection using<br>stapling suture devices (average level of anastomosis was 3.8 cm above anal verge) and<br>anal manometry was undertaken 95 times preoperatively (N=28) and 3 month (N=26), 6<br>months (N=22) and 12 months (N=19) postoperatively from 1992 to 1995 in Korea<br>University Guro Hospital. Results : Maximum resting pressure was reduced after<br>resection (from 64.7 mmHg to 42.7 mmHg, change 22 mmHg) but gradually increased<br>and returned to preoperative level at 12 months postoperatively. Minimum perceived<br>volume was decreased after operation (from 40.3 ml to 25 ml change of 15.3 ml) and<br>this change persist at 12 months postoperatively. Rectoanal inhibitory reflex was present<br>in all patient before surgery but disappeared in most of the patient after operation.<br>Reflex returned to normal in 4 of 22 patients at 6 months later and in 7 of 19 patients<br>at 12 months after operation. Maximum squeezing pressure and maximum tolerable<br>volume were not decreased after operation. Conclusions : Anorectal function (maximum<br>resting pressure, minimum perceived volume and rectoanal inhibitory reflex) was<br>reduced immediately after low anterior resection of rectal cancer. But this functional<br>changes returning to normal at 6 months and most of the patients had good function at<br>12 months after operation.<br>