A groundbreaking anal preservation theory: sufficient pelvic floor muscle function can retain significant defecation function after in-situ anal reconstruction surgery

Abstract

Currently, patients with ultra-low rectal cancer/anal canal cancer usually undergo an abdominoperineal resectionwith sigmoid colostomy. Patients commonly experience a poor quality of life post-surgery, often feeling that their dignity has been compromised. Some patients are even willing to forego treatment rather than lose their anus. To explore the patients with ultra-low rectal/anal canal cancer who have well function of pelvic floor muscle before surgery can still retain clinically significant defecation function after undergoing combined procedures of partial pelvic floor muscle resection and in-situ anal reconstruction. After 6 months postoperatively,patient 1’s Wexner scores was 9, and she reported effective control over bowel movements. After 24 months postoperatively, the Wexner scores was 12 for patient 2, and 16 for patient 3. Patient 2 can effectively suppress fecal discharge, experiencing only 2-3 episodes of fecal incontinence per week. Patient 3 can perceive the urge for defecation and can consciously inhibit bowel movement for approximately 20s. Patients who have well-functioning pelvic floor muscle can undergo combined procedures of partial pelvic floor muscle resection and in-situ anal reconstruction.