Abdomino-anal pull-through excision for tumours of the mid-third of the rectum: A comparison with low anterior resection

Force in the anal canal and anal continence.

“…The failure to explain this response on neuromuscular grounds has led to suggestions that the physical characteristics of the anal canal may contribute to the pressure recorded (Phillips and Edwards, 1965;Duthie and Watts, 1965). Our results using the force gauge would seem to lend support to a physical explanation of the decrease in pressure in the anal canal in response to distension of the rectum.…”

“…However, we have confirmed our previous results showing that, when 100 ml. of air was used to distend the upper rectum, a decrease in pressure in the anal canal occurred promptly and the electrical activity of the external anal sphincters showed no diminution (Duthie and Watts, 1965). If distension were continued to the level required to produce inhibition of the electromyogram (250 to 300 ml.…”

“…A possible criticism of this physical explanation is that in patients who have had an anterior resection, distension of the rectum below the suture line gives rise to this decrease of pressure in the anal canal, whereas distension in the colon above the suture line does so only occasionally (Goligher, Duthie, Dedombal, and Watts, 1965). In these cases fibrous scar tissue may prevent the rectal walls being pulled up and hence diminish the effect on the anal canal.…”

Estudo retrospectivo de 47 complicações em 380 pacientes operados de câncer retal

“…A impotência sexual e a bexiga neurogênica, alguns autores têm com elevada freqüência em pacientes idosos - Baslev 36 , Bokey (1990) 8 , Cunsolo (1989) 30 , Gillen (1986) 40 , Halpern (1989) 52 , Hughes (1980) 54 e Rothenberger (1990) 84 , tamanha a discrepância entre os dados da literatura (Tabela-8 Goligher (1965), Vidal-Lobo (1966), Candioti (1966), Kratzer (1967), Kennedy et al (1971), Cutait (1970), Dubois (1971), Habr-Gama (1972), Enker et al (1979), Bokey (1990), Cunsolo (1989), Gillen (1986), Halpern (1989), Hughes (1980) e Rothenberger (1990) abdominoperineal em nossa casuística (dois óbitos em 135 pacientes amputados) foi de 1,5%. A menor taxa de incidência de mortalidade, certamente se deve ao fato de a maioria das cirurgias levantadas pelos autores assinalados terem sido realizadas algum tempo antes de nossa análise.…”

Sphincter preserving techniques: from anterior resection to coloanal anastomosis

“…Since the works of Parks [34] and Goligher et al [10] sphincter-saving surgery for tumors of the middle and distal rectum has been a constant issue. At our own Department the proportion of patients undergoing abdominal perineal extirpation of the rectum decreased from 39% at the end of the 1970s to 19% at the end of the 1980s and is now approx.…”