Objective
To assess the use of gluteus maximus muscle to reconstruct the anal sphincter for very low rectal cancer. This study aimed
to evaluate the local recurrence and function of the new anal sphincter after operation.
Methods
Sixteen patients underwent the replacement operation, and then received biofeedback treatments 1 month after the operation.
The therapeutic responses were evaluated using the Vaizey and Wexner scoring systems and vectorial manometry. The controls
were 30 cases who had undergone a low anterior resection for rectal cancer and 30 healthy people.
Results
Median follow-up was 4.2 years. No local recurrence was observed. The Vaizey and Wexner scores and vectorial manometry 1 month
after operation were significantly lower than those of the healthy and low anterior resection controls (P <0.001). After biofeedback
treatments, the above indexes improved significantly (P <0.001), especially after 1 year (P <0.001), but still remained lower
than the controls(P <0.001). The rectoanal reflex only increased to 31.3 % 1 year after operation.
Conclusion
The local recurrence after the replacement operation was low. The defecation function was poor early after operation, but
increased markedly after biofeedback treatments and long-term functional exercise. This therapy can be one choice for very
low rectal cancer.
Keywords low rectal cancer - gluteus maximus - defecation function
This work was supported by a grant from the University Science and Technique Research Program of the Education Department
of Liaoning Province (No.05L484)