new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation: Anorectal mobilization in the treatment of rectal lesions, further study

ABSTRACT

The technique of anorectal mobilization was surveyed in 85 patients who underwent the operation 5 to 10 years ago and who were followed up until death or 1982. Rectal pressure and myoelectric studies were done. The operation was performed in 45 patients with huge rectal papillomas which carpeted the whole circumference and were 3 to 6 cm from the rectal neck outlet. No complications were encountered and the results were satisfactory. The 40 patients with lower 1/3 rectal cancer have the tumor 4 to 6 cm from the rectal neck outlet. Four patients were stage A Dukes' classification, 14 stage B and 22 stage C. The 5 year survival was 62%. The 25 survivors, more than 5 years now, had normal continence and defecation. The mechanism of continence in these patients was discussed. The role of puborectalis and external sphincter in involuntary continence was clarified