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概要: Recently, function-preserving surgery has become more widely applied to patients with rectal cancer. Compared with abdom … ioperineal resection, sphincter-saving procedure generally leads to an improved quality of life（QOL）. However, straight colo-anal anastomsis（St type）for extremely low rectal carcinoma often causes a deterioration. Therefore, we have performed colonic J pouch-anal anastomosis（J type）since 1988. Forty patients who received the J type and 14 who received the St type are discussed. Mean daily stool frequency was 2.4 at 12 months after surgery in the J group, significantly lower than 5.0 in the St group. Frequent bowel movements and urgency placed restrictions on daily life in 29% of the St group, while there were no severe restrictions in the J group. An increased number of patients are undergoing autonomic nerve-preserving procedures, and good functional results have been obtained. The incidence of urinary dysfunction requiring consultation with a urologist was lower in the autonomic nerve-preserving group（3.4%）than in the non-preserving group（34.8%）. Some sexual dysfunction was found in 14.3% of the autonomic nerve-preserving group, and in 92.3% of the non-preserving group. These results that the sphincter and autonomic nerve-preserving procedures produce good postoperative QOL. 続きを見る

概要: The aim of this study was to investigate the curability of a sphincter-saving operation using a colonic J pouch-anal ana … stomosis for lower rectal carcinoma and the postoperative result of urinary function after an autonomic nerve preservation procedure. Materials and methods：Forty-three patients who were treated with coloanal anastomosis, 33 of whom received the J type and 10 the straight type, were discussed. Results：The total rate of recurrence of rectal carcinoma（n＝39）was 20.5%, with a 17.9% rate of distant metastasis and a pelvic recurrence rate of 2.6%, but no anastomotic recurrence. The five-year survival rate after curative resection was 84.3% in all cases. The incidence of neurogenic bladder was a lower rate in autonomic nerve preserving group（16.7%）than in autonomic nerve non-preserving group（53.8%）. Conclusion：The sphincter-saving operation with colonic J pouch-anal anastomosis does not prejudice cure of this carcinoma. And the autonomic nerve preservation procedure was successful in minimizing urinary dysfunction. 続きを見る

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