Chin J Bases Clin General Surg Vol 21 No 5 May DOI /

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1 Chin J Bases Clin General Surg Vol 21 No 5 May Wexner Wexner Wexner 9 R657 1 A Evaluation and Treatment for Fecal Incontinence after Sphincter-Preserving Operation for Middle and Low Rectal Cancer PI Yan-na 1 XIAO Yi 2 FANG Xiu-cai Department of Gastroenterology Peking Union Medical College Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China 2. Department of Surgery Peking Union Medical College Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China Corresponding Author FANG Xiu-cai fangxiucai2@aliyun. com Abstract Objective To understand the incidence of fecal incontinence after sphincter-preserving operation for middle and low rectal cancer the factors influencing fecal incontinence the relationship of fecal incontinence to anorectal manometry and treatment. Method The literatures about fecal incontinence after sphincter-preserving operation for middle and low rectal cancer were reviewed. Results The incidence of fecal incontinence after sphincter-preserving operation for middle and low rectal cancer was about Wexner fecal incontinence score was the most popular scale in assessing the severity of fecal incontinence which had high validity and utility. When Wexner score 9 the fecal incontinence-related quality of life was seriously damaged. Closer the anastomosis to the anal margin the fecal incontinence was more likely to happen and much severer if it appeared. Surgeon could improve the anorectal function through some kinds of surgeries like ultralow anterior resection with levator-sphincter reinforcement when the tumor site was rather low. The effect of chemoradiotherapy on fecal incontinence was uncertain now. Age itself was a risk factor for fecal incontinence for elderly patients underwent sphincter-preserving operation needed to be careful. The relationship of fecal incontinence to anorectal function was not completely clear. The anal sphincter nerve function was a predicting factor whether neurogenic fecal incontinence was going to happen or not. Even though the retrograde colonic irrigation sacral nerve stimulation and biofeedback therapy had been proved to alleviate the symptoms and improve the quality DOI / AA BAI04B fangxiucai2@aliyun. com piyanna@126. com

2 Chin J Bases Clin General Surg Vol 21 No 5 May 2014 of life after sphincter-preserving operation much more prospective and controlled studies were needed to validate their efficacy and explore other new solutions. Conclusions We still need to come up with the objective criterion to assess fecal incontinence. Much more prospective studies are needed to analyze the influencing factors and to find effective prevention and treatment. Key words Rectal cancer Fecal incontinence Anorectal function Treatment Foundation item Project of The National High-Tech R & D Program 863 Program No. 2010AA National Key Technologies R & D Program in The 11th Five Year Plan Period No. 2007BAI04B cm 2 cm Wexner 8 Cleveland Wexner Vaizey AMS Pescatori Wexner Wexner Wexner Matzel 12 3 cm 4 6 cm 7 9 cm 10 cm Wexner 1 1 cm Wexner 1 2 cm 2 3 cm

3 Chin J Bases Clin General Surg Vol 21 No 5 May J / Kim NCCN 21 T 3 T 4 T Pucciarelli AMS d Wexner ? NCCN Gy Gy/ Gy 5 Gy/ P

4 Chin J Bases Clin General Surg Vol 21 No 5 May 2014 Lee 29 4 cm Koda Wexner 5 Wexner mm 15 1 mm 35 1 mm 24 9 mm P mm Hg 1 mm Hg kpa Wexner Kneist d Rosen Cleveland Wexner J (1) 1-12 Shibata D Guillem JG Lanouette N et al Functional and qualityof-life outcomes in patients with rectal cancer after combined

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