Abstract
Barium rectography was done by inserting an Fr. 8 catheter into the anus. The degree of pelvic floor (or anorectal angle) ascent was measured from the rectogram obtained by pushing the anus upward. The anal canal length ranged from 3.0 to 4.4cm (mean 3.7cm) in males, and from 2.5 to 3.8cm (mean 3.2cm) in females. The pelvic floor ascent ranged form 1.8 to 3.4 cm (mean 2.5cm) in males, and from 3.0 to 4.0cm (mean 3.5cm) in females. Therefore, a device to push up the anus was used during the operation for lower rectal cancer. A good field of vision of the pelvic floor was offered by this device.
Super-low anterior resection by stapled colo-anal canal anastomosis has made it possible by using this device. A retrospective study on 101 patients with middle and lower rectal cancer undergoing low anterior resection was conducted. Stapled anastomosis within the anal canal was made in 11 patients with lower rectal cancer, who had lesions ranging from 4.0 to 5.4 cm from the anal verge. The postoperative level of stapled anastomosis ranged from 2.0 to 3.0 cm (mean 2.5cm) from the anal verge, and accorded with the upper margin of the postoperative anal canal. Therefore, the preoperative anal canal length of 3.6cm (ranging from 3.0 to 4.2cm) became shorter, to 2.5cm, postoperatively.
