Complications after intersphincteric resection related to defecation disorder include increase in stool frequency, urgency of defecation, and fecal incontinence. When the use of an absorbent pad is continued, the defecation function improves over time and then levels out after approximately two years. Anal manometry is used to monitor the defecation function, but there is often a poor correlation between the findings from manometry and the actual defecation situation. Proctectomy preserving the anus has decreased retention and stool storage function, and retention of the intestinal tract contents is difficult. The sphincter muscle of the anus is weakened by ISR, incurring functional disturbance and defecation abnormality with decreased QOL for the patient. Changes in physiological function are caused not only by operative anatomical changes but also by the therapeutic methods including preoperative chemoradiotherapy, reconstruction method, and any complications such as anastomotic leakage. In order to improve the indications for surgery and reduce postoperative functional disorders, further studies and more precise preoperative evaluation methods are needed.
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