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Low anastomosis with covering stoma is the standard operation for low rectal carcinoma. Some patients experience severe anorectal disorder, which makes us consider whether stoma closure should be performed or not. There was no comparative study between life with a stoma and life with evacuatory disorder. Covering stoma was closed at 4 to 6 months after ultra-low anterior resection. Forty-five patients were evaluated by questionnaire in terms of their bowel evacuation and anorectal manometry before ultra-low anterior resection and 6 months after stoma closure. They were also questioned about their subjective preference regarding the life before and after stoma closure. After stoma closure, frequency of daily bowel movement was significantly increased up to 5 times (range 2-15). Incontinence score was also significantly worsened from 0 to 8, postoperatively. All patients complained of any influence in their social life. Ninety-three percent (42/45) of the cases were dissatisfied with evacuation, postoperatively. Eighty-nine percent (40/45) of the cases had postoperative evacuatory disorder defined by the present study. Under these backgrounds, all patients replied that evacuation from the anus was superior to life with a stoma even during postoperative evacuatory disorder status. Even when patients had evacuatory disorder, they preferred life without a stoma according to their subjective opinion.


Hiroyoshi Matsuoka, Tadahiko Masaki, Takaaki Kobayashi, Kazunori Sato, Toshiyuki Mori, Masanori Sugiyama, Yutaka Atomi. Which is the preference of choice either life with a stoma or evacuatory disorder following rectal cancer surgery? Hepato-gastroenterology. 2011 May-Jun;58(107-108):749-51

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PMID: 21830383

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