Fecal continence after subtotal to total excision of the rectum

From a technical and oncologic point of view, low anterior resection of the rectum can be performed in selected patients, but fecal continence after these procedures is often questioned. Therefore we have investigated the mechanism of continence, i.e. the internal and external sphincters, anal and rectal sensibility, and rectal capacity in 17 patients who had undergone anterior or low anterior resection. Normal anal and rectal sensation was found in all patients. Adequate sphincteric function was maintained to guarantee normal sphincteric continence postoperatively. Rectal capacity was reduced in patients with very low rectal resections. This caused an increase in bowel actions, and a reduced ability to delay imminent evacuation. It was concluded that fecal continence is reduced after very low rectal resections.